Guest House Bed & Breakfast Proposal Form

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Personal Details

Your Name and Business Name*:
(including all trading names, group companies and subsidiaries to be covered by the policy)

Risk Address*:

Postcode*:

Telephone Number*:

Email Address*:

Renewal Date*:
(from which cover is required)

Current Insurer*:

Renewal Target Premium*:

Full Business Description*:
(Hotel, Guest House or B&B)

Number Of Years Trading From This Premises*:

Number Of Years Experience Within This Or An Associated Industry*:

Have any Insurers ever?

Declined Your Proposal:

NoYes

Please give details*:

Refused To Renew Or Cancelled Your Policy:

NoYes

Please give details*:

Imposed Special Conditions:

NoYes

Please give details*:

Has any partner, director or principal ever been convicted or tried with any Criminal convictions other than motoring:

NoYes

Please give details*:

Has any partner, director or principal received any CCJ's, any bankruptcies or every had a company go into liquidation or administration:

NoYes

Please give details*:

Have you sustained any loss or damage during the last 5 years which would have been covered by this type of policy had it been in force:

NoYes

Date:

Circumstances:

Amount:

Status:

Prevention:

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Construction Details

Construction of walls*:

StandardOther

Please include details of the composition of any part that is not brick or stone and it's approximate percentage of the total:*:

Year Of Build*:

Is This A Listed Building:

NoYes

Construction of Roof*:

Slate/Tile PitchedOther

Please give full details e.g flat felt, concrete etc and include its approximate percentage of the total:*:

Is there a flat roof?

NoYes

What percentage is flat*:

What is the construction of the flat roof*:

Please give details of the construction type*:

What type of heating system is in place*:

Please give details*:

Is there a valid fire safety certificate:

NoYes

Do you have a current satisfactory electrical report completed by a commercial approved electrician:

NoYes

What percentage of the turnover is generated from the rental of rooms*:

Please give full details of any other use*:

Does the Premises provide accommodation for any staff, management, proprietors or directors:

NoYes

Please give details*:

Is accommodation provided for Council Referrals / Council Assisted, Homeless, DSS, Asylum Seekers, Students or the like:

NoYes

Please give details*:

Are the kitchen and canopy hood range extraction system and ducting annually maintained and cleaned by professional contractors with records kept:

NoYes

Are there outbuildings at the property:

NoYes

Description:

Construction:

Sum Insured (to be included within the overall Building Sum Insured):

Does the building have a fire alarm:

NoYes

Does the building have a sprinkler system:

NoYes

Please give details* of edition, date, installed etc:

Does the building have smoke detectors:

NoYes

Please advise if these are in every room:

Security Requirements

Please tick the following protections that ARE operative at the Premises:

5 Lever Mortice Deadlocks on all Final Exit DoorsKey Operated Window LocksNacoss Bells Only (Audible) AlarmNacoss Redcare AlarmNacoss Central Station AlarmOther Alarm – please describeCCTV24 hour staff presenceManager / Owner resident on PremisesStaff resident on Premises

Wet Perils

Is there a history of flooding at the premises:

NoYes

Please give details*:

Is there a history of flooding within the immediate area:

NoYes

Please give details*:

Are you within 400m of any watercourse:

NoYes

Height above high water level:

Distance from high water level:

Building situated on a cliff:

NoYes

Please give details*:

Liability - Entertainment

Public Bar:

NoYes

Door Staff Used:

Is there Karaoke:

NoYes

Frequency Per Annum:

Door Staff Used:

Public Disco's
(not including private functions):

NoYes

Frequency Per Annum:

Door Staff Used:

Private Functions:

NoYes

Frequency Per Annum:

Door Staff Used:

Any Other:

NoYes

Frequency Per Annum:

Door Staff Used: