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© 2024 Prestige Insurance Brokers (UK) Limited

Fact find questionnaire

for FOOD & BEVERAGE PLACES

Please complete the form below to provide information about your business

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Contact Name

Position held within the business

Email

Phone number

Business insurance renewal date

Current insurer

Premium

Business Name

Trading name

Status of entity

Company registration number

Business description

Date business established at this address

Premises address: (Premises Name, Building Number, Street Name, Town, Post Code)

Business location:

High street
Arcade
Business Park
Covered Shopping Centre
Cliff
Domestic Premises
Lakeside
Market Hall
Parade
Precinct
Riverside
Seafront

How many Directors and/or Partners the business have in total?

1
2
3
4

1) Full name / Date of Birth / Position within the company:

2) Full name / Date of Birth / Position within the company

3) Full name / Date of Birth / Position within the company

4) Full name / Date of Birth / Position within the company

Select any of the following that apply to any Director or Partner of the business, if the ever:

been declared bankrupt or insolvent or been the subject of bankruptcy proceeding or insolvency proceeding
had a proposal refused or declined
had an insurance cancelled
had a renewal refused
had special terms imposed
had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or have any prosecutions pending
None

Does the business have any employees?

Yes
No

Employer PAYE No

Estimated Wageroll (next twelve months) (£)

Total number of employees

Are any employees paid below PAYE threshold?

Yes
No

(inc. LOSC, trainees, apprentices)

Which activities listed below apply to your business:

Serving Hot Food
Deep Fat Frying
Sale of Take-Away Food

Estimated Turnover (next twelve months) (£)

Turnover percentage derived from Serving Hot Food

Turnover percentage derived from Deep Fat Frying

Turnover percentage derived from Sale of Take-Away

Hygiene Rating score:

1
2
3
4
5

Is the business also the building owner?

Yes
No

Property Ownership Name

Date of purchase

What is the estimated total value of the building? (Including fixed glass, landlords' fixtures/fitting)

Year the property was built

Property type

Is the property a Listed building?

Yes
No

Provide details

Please select if any statements are applicable to the property

The business is not self contained with its own means of access
The premises is in area with history of flooding
The proposer is not the sole occupant (if other than offices or private dwellings)
There is an ATM on the premises
The property or adjacent property has suffered from, or shows any visible signs of damage from subsidence, landslip or ground heave
None

Business hours

Are there any other occupants that use the premises?

Yes
No

Please specify tenant types

Is the property is of non-standard construction?

Yes
No

(Walls not built only of brick, stone, metal or concrete or roofed only with slates, tiles, metal or concrete)

Number of storeys where floor is of concrete construction

Number of storeys where floor is of wooden construction

What materials are the property walls made of?

Please provide percentage split, if the walls are made of more than one material

What materials is the property roof made of?

Please provide percentage split, if the roof is made of more than one material

Is there an area of flat roofing?

Yes
No

If yes, please state the approximate percentage of the roof being flat

Heating and fuel type

Please select all risk management features that you use for this property

Intruder Alarm
Wired Fire Alarm
Other
Sprinklers
CCTV - 30 days recording
None

Intruder Alarm type:

Maintenance contract accredition

Accreditation of intruder alarm

Does the alarm incorporate confirmable technology?

Yes
No

Is the alarm connected to the Police response?

Please specify level

Is the alarm under the sole control of the business?

Yes
No

Are your sprinklers maintained by Loss Prevention Certification Board approved company?

Yes
No

Sprinklers accreditation details:

Other risk management features

Please specify

Business licence type:

Liquor (On-Premises)
Entertainment
Gambling
No licence

Any opposition to/incident that may prejudice the granting, renewal, or transfer of the licence?

Yes
No

Any application for the granting, renewal or transfer of the licence refused?

Yes
No

Is the intention to transfer the licence within the next twelve months?

Yes
No

Activity types

Number of times held per month?

Is a fee charged for this activities?

Yes
No

Estimated value of the Business Fixtures and Fittings (£)

Estimated total value of Electrical Equipment (£)

Estimated value of the Business Stock (£)

Please exclude: Wines, Spirits & Frozen Stock

Estimated value of Wines & Spirits (£)

Estimated value of the Frozen Stock (£)

Estimated value of tenants improvement (£)

Does the business use a Safe or Strongroom on the Premises?

Yes
No

What is the Safe Make? / Model ?/ Description /? How is it secured?

Sum required to be insured contained in a locked safe

Sum required to be insured, which are not in a locked safe

Sum required to be insured on premises during business hours

Sum required to be insured on premises outside business hours

Have you made any claim in the last 5 years?

Yes
No

Please provide: The date of the claim, Cause of the Claim, The Claim Amount & the Outcome:

Any addition information?

GDPR Agreement *

I consent to having this form submitted so Prestige Insurance Brokers (UK) Ltd can respond to my inquiry.

Email

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©2024

© 2024 Prestige Insurance Brokers (UK) Limited - Appointed Representative of TEn Insurance Services Ltd, trading as Eleven, which is authorised and regulated by the Financial Conduct Authority (FRN 314593)