Arboricultural Insurance Proposal Form

Proposer's & Business' Name

Email Address

Phone Number

Address

Start Date Required

Established Date

Years Experience

Business Activities

Height worked to (meters)

All Employees and Contractors are Qualified

Yes

Annual Turnover £

Annual Wageroll and Number of Staff

Payments to Bona-fide and/or Labour Only Sub Contractors

Risk Assessments in Place

Yes

Do You Work in Any Hazardous Locations

Yes

Property Address

Sums insured for (if Applicable), Buildings (including construction), Stock, Contents, Machinery, Plant, Tenants Improvements, Computers

Security - Alarms(Intruder/Fire) / CCTV / Gated Unit Etc.

if Contract Works is required please let us know sums for owned plant and hired in plant

Claims -Have you or any of your Directors/Partners, or any company of which any of you have been a director, or any partnership of which any of you have been a partner, sustained any loss or damage or had a claim made against you during the last 5 years?

Additional Information - In the box below, please state any additional information necessary to provide; insofar that it increases a risk or might otherwise be relied on by us to make a fair and reasonable assessment of your proposal.