Skip to content
HOME
ABOUT US
PRODUCTS
CLAIMS
CONTACT
HOME
ABOUT US
PRODUCTS
CLAIMS
CONTACT
Fact find questionnaire
for Offices anD professionals
FILL OUT THE FORM BELOW TO GET A QUOTE
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
Contact name
Position held within the business
Email
Phone number
Next
Correspondence address (If it is different from the address being insured)
Previous
Next
Insurance renewal date:
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
1
2
3
4
5
6
7
8
9
10
11
12
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Current insurer:
Premium:
Previous
Next
Business Name:
Trading name:
Previous
Next
Status of entity:
Company registration number:
If applicable
Previous
Next
How many Directors and/or Partners the business has 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:
Previous
Next
Business Trade description:
Date business established:
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
1
2
3
4
5
6
7
8
9
10
11
12
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Previous
Next
Select any of the following that apply to any Director or Partner of the Trade or Business or its Subsidiary Companies if they have ever:
had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or have any prosecutions pending
been declared bankrupt or insolvent or been the subject of bankruptcy proceeding or insolvency proceeding
been served with prohibition or improvement order under health and safety regulation
been the subject of a recovery action by Customs and Excise or the Inland Revenue
been disqualified from holding company directorship
had CCJ's and/or Sheriff Court Decrees
Not applicable
Previous
Next
Select any of the following that apply to any Director or Partner of the Trade or Business or its Subsidiary Companies if they have ever:
had insurance cancelled
had a renewal refused
had a proposal refused or declined
had special insurance terms imposed
Not applicable
Previous
Next
Does the business have any employees?
Yes
No
Previous
Next
Total number of employees:
Employer PAYE No:
Previous
Next
Estimated Wageroll (next twelve months)
Are any employees paid below PAYE threshold?
Yes
No
(inc. LOSC, trainees, apprentices)
Previous
Next
Does the business carry out any treatments?
Yes
No
Please list all the treatments that the business carry out:
Please state N/A if not applicable
Please specify the number of qualified staff for each treatment:
Please state N/A if not applicable
Previous
Next
Estimated Business Turnover (next twelve months)
Percentage of turnover derived from second hand goods?
If applicable
Previous
Next
Business address to be insured: (Property Name, Building Number, Street Name, Town, Post Code)
Previous
Next
Does the business also own the building?
Yes
No
Date of purchase:
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
1
2
3
4
5
6
7
8
9
10
11
12
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Property Ownership Name:
Land Registry Title
Previous
Next
Business hours:
Are there any other occupants that use the premises?
Please specify tenants types
Previous
Next
Is the business self-contained with its own means of access?
Yes
No
Previous
Next
Is the property in area with history of flooding?
Yes
No
Previous
Next
Is the property of non-standard construction?
Yes
No
[walls not built only of brick, stone, concrete or roofed only with slates, tiles or concrete]
Previous
Next
Is there an ATM on the premises?
Yes
No
Previous
Next
Is the premises in a good state of repair and free from damage?
Yes
No
Previous
Next
Is the property a listed building?
Yes
No
Please specify listing grade:
Previous
Next
Number of storeys where floor is of concrete construction
Number of storeys where floor is of wooden construction
Previous
Next
What materials are the property walls made of?
Please provide percentage split, if the walls are made of more than one material
Previous
Next
What materials is the property roof made of?
Please provide percentage split, if the roof is made of more than one material
Previous
Next
Is there an area of roofing flat?
Yes
No
Please state the approximate percentage of the roof being flat?
Previous
Next
Heating and fuel type:
Previous
Next
Please select all risk management features that you use for this property:
Wired Fire Alarm
Intruder Alarm
Sprinklers
Other
None
Previous
Next
Is the intruder alarm maintained by accredited company?
Yes
No
What type of signalling your alarm has?
Redcare
Digicom
Bells only
Other
Accreditation of intruder alarm:
Is the alarm connected to the Police response?
Please specify other risk management features:
Previous
Next
Are your sprinklers maintained by Loss Prevention Certification Board approved company?
Yes
No
Sprinklers accreditation details:
Previous
Next
Please specify type of door locks
Please specify type of window locks
Previous
Next
What type of other Security Aids does the business use?
Private CCTV
Other monitored CCTV
Town Centre / Local Authority CCTV
Access Control
Shutters
Window bars
Guard dogs
Security Patrols
No additional aids
Proposer/family members or employees living above
Do you have 30 days of more recording facilities on the private CCTV?
Previous
Next
What is the estimated total value of the building? (Including fixed glass, landlords' fixtures/fitting)
Previous
Next
Estimated value of the Business Fixtures and Fittings
Estimated value of the Electrical Equipment
Previous
Next
Estimated value of the Business Stock
If applicable, please exclude: Wines, Spirits, Tobacco and Cigarettes
Estimated value of the Business Frozen Stock
Previous
Next
Estimated value of the Tenant Improvement
Estimated value of the Shop or Salon Front
Previous
Next
Does the business sell any Tobacco, Cigarettes, Wines or Spirits?
Yes
No
Previous
Next
Estimated value of Wines and Spirits
Estimated value of Tobacco and Cigarettes
Previous
Next
Does the business keep any money in Safe or Strongroom on the premises?
Yes
No
Please provide the Safe Make - Model - How is it secured?
Previous
Next
Have you had any insurance claims within the last 5 years?
Yes
No
Previous
Next
Please provide: The date of the claim, Cause of the Claim, The Claim Amount & the Outcome:
Previous
Next
Any addition information?
Previous
Next
GDPR Agreement
*
I consent to having this form submitted so Prestige Insurance Brokers (UK) Ltd can respond to my inquiry by phone, email or a message.
Previous
Email
Submit
Rest assured, your information will be held in strict confidence.