• Welcome
  • Products & Services
  • Terms of Business
  • Insurers
  • FSA
  • Application Forms
  • Contact Us
Welcome
Welcome Header 2

GRS Are A Specialist Insurance Intermediary Providing A Range Of Insurance Solutions And Risk Management Advice To Individuals And Companies Operating Within The Construction And Contracting Trade Sectors, Including Those Deemed To Fall Into “High Hazard” Categories.

Based in the historical town of Rochford in Essex we offer a comprehensive insurance service throughout the United Kingdom. From sole traders to multi-million turnover organisations, we pride ourselves on delivering the same quality service whatever the size of your business.

GRS is committed to providing an outstanding level of service to both existing and prospective clients. We undertake a full fact find at the enquiry stage to help us understand all aspects of your business, and then formulate a detailed risk presentation for insurers on your behalf. This provides insurers the opportunity to put forward their best possible pricing.

GRS promise to give you independent, consistent advice on all aspects of your insurance program, discuss with you uninsured risk exposures and ultimately help you find insurance and risk management solutions at highly competitive terms.

We are members of the British Insurance Brokers Association (BIBA) and fully conform to their general operating standards and procedures.

Our team look forward to hearing from you.

Products & Services
Products & Services2

Our considerable market expertise, built up over many years operating in a specialist trade sector, puts us in a unique position to offer free advice and assistance to a diversity of clients from a basic owner run business to the more complex risk.

When considering their insurance requirements many businesses will inevitably focus on their legal liability exposures to employees and third parties, potentially areas of greatest concern. Our services include provision for both Employer’s Liability and Public Liability Insurance and, in addition, embrace various other classes. These include:

  • BONDS AND SURETY
  • BUSINESS INTERRUPTION
  • CARGO AND TRANSIT
  • COMMERCIAL COMBINED
  • CONTRACTORS PLANT
  • CONTRACT WORKS AND JCT 21.2.1
  • DIRECTORS AND OFFICERS LIABILITY
  • ENGINEERING INSURANCE AND INSPECTION
  • HIRED IN PLANT
  • MOTOR FLEET AND COMMERCIAL VEHICLES
  • PERSONAL ACCIDENT
  • PROFESSIONAL INDEMNITY
  • PROPERTY DAMAGE AND PROPERTY OWNERS

This list is quite extensive but is not intended to be exhaustive. Please contact GRS for information on any insurance related area that falls outside of these guidelines.

High Risk Exposures

Our core business, and therefore one of our greatest areas of expertise, is the provision of insurance solutions for organisations operating within what are deemed to be “high hazard” or “high risk” environments.

Such trades could include:

  • CLIENTS OPERATING AT CONSIDERABLE HEIGHT OR DEPTH
  • CLIENTS HANDLING HAZARDOUS CHEMICALS OR MATERIALS
  • CLIENTS INVOLVED IN DEMOLITION ACTIVITIES
  • CLIENTS OPERATING WITHIN NUCLEAR OR OTHER RESTRICTED SITES, AIRPORTS, DOCKS AND THE LIKE.

Please feel free to contact us to take advantage of our many years experience in this field.

Terms of Business
Terms of Business2

Terms of Business (Statutory Trust) Company Registration no 5638109 England

The Financial Services Authority:

The FSA is an independent watchdog that regulates financial services. It requires that we should give you access to our terms of business. Please use this information to decide if our services are right for you.

Under our FSA status our permitted business is advising on, arranging, transacting and administering general insurance contracts.

Our services

We are an independent insurance intermediary and will act on your behalf in:

  • Arranging your insurance cover with insurers to meet with your requirements or, where requirements cannot be fully met, provide you with enough information to enable you to make an informed decision.
  • Helping you with any changes that you need to make to your insurance during the policy period.
  • Telling you when you need to renew your policy in time to allow you to consider and arrange any continuing cover.

The full wording of our terms of business is available on request.

Insurers
Insurers2

GRS always work with insurers experienced in the specific trade sectors relevant to your business. The benefits of working with insurers that fully understand your business are demonstrated by cost effective policies that meet your demands and needs.

Our breadth of experience gives us direct access to the vast pool of UK general insurance companies and a number of specialist Underwriting Agencies. Using other long-standing business relationships we are also in a position to access all areas of the London Market including Lloyds.

We are always seeking to build on our panel of insurers and to keep you informed of significant industry developments, and emerging markets. New products and services are all closely monitored so that we can pass on any benefits to you.

FSA
FSA2

The Financial Services Authority (FSA) is an independent body that regulates the financial services industry in the United Kingdom. They have been given a wide range of rule making, investigative and enforcement powers in order to meet four statutory objectives - market confidence, public awareness, consumer protection and the reduction of financial crime.

Genesis Risk Solutions Limited are fully authorised and regulated by the FSA under registration no 463687. This can be checked and verified by visiting www.fsa.gov.uk/register

Application Forms
Application Forms2

To obtain a quotation from GRS simply select and complete one of the forms below. When you have completed the form, click submit and a member of our staff will then contact you to acknowledge receipt and to request any additional information that may be required.

Commercial Combined Application Form

1. General Information

Your name is required.
Minimum number of characters not met.

Position is a required.

A telephone number is required.Please enter a valid telephone number.


An email address is required.Please enter a valid email address.

A company name is required.Minimum number of characters not met.

Please select a trading status.


Please enter a valid address.
Please enter a valid address.

A postcode is required.Invalid postcode.


A postcode is required.Invalid postcode.


Please enter a business description.
Please enter a business description.


A value is required.Please enter a valid number of years at premises.Please enter a valid number of years at premises.


Please describe other interested parties.
Please describe other interested parties.

A date is required.Invalid date.

2. General Questions

2.1. Have you or any partner, director or principal shareholder in the Business either in a domestic or business capacity:
(A) Ever been refused insurance or had any special terms or conditions imposed by an insurer?
Yes No Please make a selection.

(B) During the last five years sustained any loss or had any claim made against you, whether insured or otherwise, in connection with any of the types of insurance for which cover is required?
Yes No Please make a selection.

(C) Ever been convicted of or is any prosecution pending for any offence involving dishonesty of any kind? (e.g. involving fire, fraud, theft or handling stolen goods)
Yes No Please make a selection.


2.2. Have you or any principal in the business or any company in which you have had an interest been declared bankrupt, the subject of bankruptcy proceedings or made any arrangement with creditors?
Yes No Please make a selection.


2.3. Are the Buildings at the Premises or any part of them unoccupied or occupied by any anyone other than you?
Yes No Please make a selection.


2.5. Are the Buildings at the Premises:
(A) Built of brick, stone or concrete and roofed with slates, tiles, metal or concrete, asbestos or slabs composed entirely of incombustible mineral ingredients?
Yes No Please make a selection.

(B) In an area which is subject to flooding or in an exposed position or close to any rivers, streams or other water courses?
Yes No Please make a selection.

(C) In a good state of repair and free from damage or any defect of any kind?
Yes No Please make a selection.

(D) Heated only by fixed oil, electricity or gas installation? (but not LPG)
Yes No Please make a selection.

2.6. Are the Buildings at the Premises detached from other Buildings?
Yes No Please make a selection.


2.7. In respect of the Building please state:
A value is required.Invalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.

Please select an item.

Yes No Please make a selection.


(D) The age of the electrical installation:
A value is required.Invalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.

(E) When last inspected by a qualified electrician:
An answer is required.

(F) Whether an IEE certification has been issued:
Yes No Please make a selection.

An answer is required.Minimum number of characters not met.


Minimum number of selections not met.Maximum number of selections exceeded.

A value is required.Invalid format.The entered value is greater than the maximum allowed.

2.8. In Respect of the Buildings:
(A) Are all external doors protected by Five Lever Mortice Deadlocks?
Yes No Please make a selection.

Yes No Please make a selection.


Yes No Please make a selection.

If YES please state:

Yes No Please make a selection.

Invalid format.

Yes No Please make a selection.



Minimum number of selections not met.Maximum number of selections exceeded.

3. Material Damage

Please select an item.

Yes No Please make a selection.


Yes No Please make a selection.


Invalid format.The entered value is greater than the maximum allowed.

Yes No Please make a selection.

Yes No Please make a selection.

Yes No Please make a selection.

3.7. Please state the Sum Insured required in respect of:
A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.


A value is required. Invalid format.

3.8. Please specify separately the values relating to the following, that DO ALREADY form part of the Sums Insured that you have mentioned above:
A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

A value is required.Invalid format.

4. Business Interruption

Please select an item.

4.2. Please indicate Basis of Cover:
Minimum number of selections not met.Maximum number of selections exceeded.
Invalid format.

Minimum number of selections not met.Maximum number of selections exceeded.
Invalid format.

Minimum number of selections not met.Maximum number of selections exceeded.
Invalid format.

Notes:

The Sum Insured for (a) or (b) above should represent the anticipated Gross Profit/Revenue during the maximum Indemnity period beyond the year of Insurance.

The Sum Insured for (C) above should represent the anticipated cost which would be incurred in re-establishing the Business following Interruption.

Please select an item.

Notes:

The maximum Indemnity Period should be the greatest length of time during which the Business could be interrupted or disrupted following physical damage to the Property.

4.4. Is Cover to include interruption following damage:
Yes No Please make a selection.

If YES please state:
Please select an item.



Yes No Please make a selection.

Yes No Please make a selection.

5. All Risks-Business Equipment

If you require specific All Risks Insurance on specified items please indicate against each item the Description, Make, Model, the Territorial limits that you need and the Sum Insured.
no.
Description
Make
Model
Territorial Limits
Sum Insured

1

2

3

4

5

6

7

8

9

10


6. Money

When answering the following questions the term MONEY should EXCLUDE cross cheques, cross giro cheques, cross postal orders or money orders, crossed bankers and/or giro drafts, un expired units in franking machines, stamped national insurance cards, national savings certificates, premium bonds, credit card vouchers and VAT purchasing invoices.
6.1. Please State:
A value is required. Invalid format.

A value is required. Invalid format.

(C) Details of safes and strong rooms and the amount of money contained therein out of Business hours in respect of which insurance is required.
no.
The Premises
Make
Model
Name
Amount

1

2

3

4

5

6


Yes No Please make a selection.

If you answered YES to 6.2. please answer the following:
Yes No Please make a selection.

(B) Can such Money be excluded from this insurance?
Yes No Please make a selection.

(C) please state the estimated annual carryings by the Security Company

Yes No Please make a selection.

If you answered YES to 6.3. and you require Personal Injury benefits larger than £5,000 for Death and Permanent Disability and £50 per week for Temporary Total Disability please state amount required:
A value is required.

A value is required.

7. Glass

Please indicate cover required:
Please make a selection.
Sum Insured:
Please make a selection.

Automatic Covers
A value is required.
(A) Sanitary Ware

Automatic Covers
A value is required.
(B) External Signs

Automatic Covers
A value is required.
(C) Lettering and Alarm Fails

Automatic Covers
A value is required.
(D) Frames and Framework

Automatic Covers
A value is required.
(E) Goods on Display

Total Sum Insured:
A value is required.
Total Sum Insured:


8. Goods In Transit

NOTE: Standard Goods in Transit cover excludes furs, Jewellery, precious stones, precious metals, pictures, paintings, works of art, bullion, explosives and goods of a dangerous nature unless specifically requested
Please describe goods to be insured in transit.

A value is required.

Yes No Please make a selection.

A value is required.

8.3 In respect of property in transit by your own vehicles, please state:
A value is required.

A value is required.

A value is required.

Yes No Please make a selection.


8.5 In respect of property in transit by road, carriers, rail or post, please state:
(A) The estimated total value of property in transit during the next 12 months:
A value is required.

(B) The maximum value of any one consignment by rail, road or carrier:
A value is required.

(C) The maximum value of any one consignment by post:
A value is required.

Yes No Please make a selection.

A value is required.

9. Deterioration of Refrigerated Stock

9.1 If you have refrigerated or frozen stock in machines (up to 10 HP) which are less than 15 years old and you wish to include deterioration of such stock due to failure of these machines then please state:
no.
Description
Make of Refrigerator/Freezer
Model
Age-in Years
Sum Insured

1

2

3

4

5

6

Yes No Please make a selection.

10. Book Debts

10.1 Please state:
A value is required.

A value is required.

A value is required.

Yes No Please make a selection.

10.3 Please State:
Yes No Please make a selection.

Yes No Please make a selection.

A value is required.


Please make a selection.

A value is required.

11. Loss Of License

Please select an item.

A value is required.

11.3 Please State:
Yes No Please make a selection.

Yes No Please make a selection.

Yes No Please make a selection.

Yes No Please make a selection.

12. Computer Breakdown

Note: This section covers costs following the Breakdown of your Computers. Computers for which you do not have a full maintenance contract in force with either the manufacturers or specialist engineers are excluded from this Section.
12.1 Please state the sum insured required on:
A value is required.

A value is required.

A value is required.

Please select an item.

Supplementary Details Section

Important - Please give any further details in the Supplementary Details Section below including where appropriate the nature of work, the countries involved, the turnover and/or wages applicable clearly indicating to which questions such further details refer.

Declaration

I/we declare that the foregoing statements and particulars are true and complete and I/we have disclosed all material facts and that this Proposal shall form the basis of the contract between me/us and the Insurers.
Please tick box to confirm.
I/we agree that if any information has been given by any other person other than me/us or if any part of this Proposal has been completed by any person other than me/us that person is my/our agent for that purpose.
Please tick box to confirm.
I/we agree to accept a policy of insurance subject to the terms and conditions of the Insurers policy/policies and that the Insurance(s) will not be in force until the Proposal has been accepted by the Insurers except to extent of any official cover note which it may issue.
Please tick box to confirm.












Contractors All Risks Application Form

1. General Information

Your name is required.
Minimum number of characters not met.

Position is a required.

A telephone number is required.Please enter a valid telephone number.


An email address is required.Please enter a valid email address.

A company name is required.Minimum number of characters not met.

Please select a trading status.


Please enter a valid address.
Please enter a valid address.

A postcode is required.Invalid postcode.


A postcode is required.Invalid postcode.


Please enter a business description.
Please enter a business description.


A value is required.Please enter a valid number of years at premises.Please enter a valid number of years at premises.


Please describe other interested parties.
Please describe other interested parties.

A date is required.Invalid date.

2. Contractors All Risks Information

2.1 Estimated Annual Turnover:
£ A value is required.
Invalid format, please enter a number.

2.2 Maximum Anticipated Contract Value Any One Contract:
£ A value is required.
Invalid format, please enter a number.

2.3 Average Value Any One Contract:
£ A value is required.
Invalid format, please enter a number.

2.4 Maximum Duration Any One Contract:
Months A value is required.
Invalid format, please enter a number.

2.5 Average Duration Any One Contract:
Months A value is required.
Invalid format, please enter a number.

2.6 Maintenance Period Required Any One Contract (Usually 12 Months):
Months A value is required.
Invalid format, please enter a number.

2.7 Total Sum Insured Required On Own Plant:
£ A value is required.
Invalid format, please enter a number.

2.8 Maximum Value Any One Item Own Plant:
£ A value is required.
Invalid format, please enter a number.

2.9 Maximum Value Any One Item Of Plant Hired In:
£ A value is required.
Invalid format, please enter a number.

2.10 Estimated Annual Charges For Plant Hired In:
£ A value is required.
Invalid format, please enter a number.

2.11 Is Plant Hired In Under Cpa Conditions Or Similar?
Yes No Please make a selection.

2.12 Type Of Plant Hired In:

2.13 Do You Hire Plant Out?
Yes No Please make a selection.

2.14 If So, Do Cpa Conditions Apply?
Yes No Please make a selection.

2.15 Is Cover Required For Employees Tools?
Yes No Please make a selection.

2.16 If So:
A) Maximum Sum Insured Any One Employee
£ A value is required.
Invalid format, please enter a number.

B) Number Of Employees
A value is required.
Invalid format, please enter a number.

2.17 Are You Familiar With The Joint Code Of Practice For Fire Prevention On Contract Sites?
Yes No Please make a selection.

2.18 Is Smoking Restricted To Designated Site Areas Only?
Yes No Please make a selection.

3. Does Your Site Safety And Security Arrangements Include:

3.1 Storage Of Materials
Yes No Please make a selection.

3.2 Control Of Access/Egress To Site By Visitors
Yes No Please make a selection.

3.3 Full Site Perimeter Fencing And Boarding
Yes No Please make a selection.

3.4 Special Arrangements For Securing Valuable And Portable Equipment Outside Of Working Hours
Yes No Please make a selection.

3.5 Are Larger Items Of Plant Coded, Security Marked Or Fitted With Tracking Devices?
Yes No Please make a selection.

3.6 Is Plant Registered With A Scheme? E.G. The Equipment Register
Yes No Please make a selection.

3.7 Are You Citb Registered?
Yes No Please make a selection.

3.8 Are You Iso 9001 Or Similar Accredited?
Yes No Please make a selection.

3.9 Are You Members Of Any Trade Association?
Yes No Please make a selection.

If You Answered YES to 3.9 Please Give Details:

3.10 Do You Undertake Any Work Offshore Or Outside Of The Uk? If So, Please Give Details:

3.11 Please Summarise Below Your 5 Year Claims History:
An answer is required.

Declaration

I/we declare that the foregoing statements and particulars are true and complete and I/we have disclosed all material facts and that this Proposal shall form the basis of the contract between me/us and the Insurers.
Please tick box to confirm.
I/we agree that if any information has been given by any other person other than me/us or if any part of this Proposal has been completed by any person other than me/us that person is my/our agent for that purpose.
Please tick box to confirm.
I/we agree to accept a policy of insurance subject to the terms and conditions of the Insurers policy/policies and that the Insurance(s) will not be in force until the Proposal has been accepted by the Insurers except to extent of any official cover note which it may issue.
Please tick box to confirm.












Combined Liability Application Form

1. General Information

Your name is required.
Minimum number of characters not met.

Position is a required.

A telephone number is required.Please enter a valid telephone number.


An email address is required.Please enter a valid email address.

A company name is required.Minimum number of characters not met.

Please select a trading status.


Please enter a valid address.
Please enter a valid address.

A postcode is required.Invalid postcode.


A postcode is required.Invalid postcode.


Please enter a business description.
Please enter a business description.


A value is required.Please enter a valid number of years at premises.Please enter a valid number of years at premises.


Please describe other interested parties.
Please describe other interested parties.

A date is required.Invalid date.


2. Combined Liability Information

2.1 Limit Of Liability
Employers Liability:
£ 10,000,000

(A) Public Liability:
£ An entry is required. Invalid format.

(B) Products Liability:
£ An entry is required. Invalid format.

2.2 Claims In Last 5 Years
An entry is required.


3. Height/Depth Work Information:

Maximum Height
Meters
Maximum Depth
Meters

0-10 Meters
%
0-1 Meters
%

10-15 Meters
%
1-2 Meters
%

15-20 Meters
%
2-3 Meters
%

Above 20 Meters
%
Below 3 Meters
%


4. Estimates/Projections For The Next 12 Months:

a
Number of Persons
Wages

Clerical and Administrative
Invalid format.
£ Invalid format.

Directors/Partners Non Manual
Invalid format.
£ Invalid format.

Directors/Partners Manual
Invalid format.
£ Invalid format.

Site Supervisory & Managerial
Invalid format.
£ Invalid format.

Direct Manual PAYE
Invalid format.
£ Invalid format.

Payments to Labour Only Sub Contractors
Invalid format.
£ Invalid format.

Others (Please specify type)
Invalid format.
£ Invalid format.

Drivers (If applicable)
Invalid format.
£ Invalid format.

Payments to BFSC including supply of own materials
Invalid format.
£ Invalid format.

Elsewhere
United Kingdom

Estimated Annual Turnover
£ Invalid format.
£ Invalid format.

Cost of Materials and Sales
£ Invalid format.
£ Invalid format.

5. Works Profile

5.1 Private And Domestic
An entry is required. Invalid format. %

5.2 Shops/Offices
An entry is required. Invalid format. %

5.3 Schools/Colleges
An entry is required. Invalid format. %

5.4 Health Centers/Hospitals
An entry is required. Invalid format. %

5.5 Industrial Units
An entry is required. Invalid format. %

5.6 Agricultural Units
An entry is required. Invalid format. %

5.7 Other
An entry is required. Invalid format. %

5.8 New Build
An entry is required. Invalid format. % Of Turnover

5.9 Heat Work Away
An entry is required. Invalid format. % Of Turnover

6. Additional Information

6.1 When Was The Business Established?
A date is required. Invalid format.

6.2 Do You Operate From Your Own Premises?
Yes No Please make a selection.

6.3 Are You Members Of Any Federations Or Industry Bodies?
Yes No Please make a selection.

If So, Details Please

Please describe other interested parties.
Please describe other interested parties.

6.4 Are You CITB Registered?
Yes No Please make a selection.

6.5 Do You Have A Health & Safety Policy In Force?
Yes No Please make a selection.

6.6 If So, Do You Have An Appointed Health & Safety Officer?
Yes No Please make a selection.

6.7 If Yes, What Is The Name Of The Person?
An entry is required. Invalid format.

6.8 Is Your Health & Safety Programme Audited Externally?
Yes No Please make a selection.

6.9 Do You Provide Health & Safety Training?
Yes No Please make a selection.

6.10 Is There A Formal Safety Training Plan For Employees?
Yes No Please make a selection.

6.11 Is There An Ongoing Training Program?
Yes No Please make a selection.

6.12 Are Risk Assessments Undertaken And Recorded?
Yes No Please make a selection.

6.13 Are Method Statements Prepared For Each Contract?
Yes No Please make a selection.

6.14 Do All Employees Undertake An Induction Prior To Employment?
Yes No Please make a selection.

6.15 Are All Employees Provided With Personal Protective Equipment?
Yes No Please make a selection.

6.16 When BFSC Are Used, Do You Check Adequate Insurance Is In Place?
Yes No Please make a selection.

6.17 If You Use Heat Applications Do You Obtain A Hot Work Permit?
Yes No Please make a selection.

6.18 Do You Work In Any Hazardous Locations (I.E. Demolition Sites, Airports)
Yes No Please make a selection.

6.19 Do You Handle Asbestos In Any Way?
Yes No Please make a selection.

If So, Details Please:

Please describe other interested parties.
Please describe other interested parties.

7. Marketing Assistance

7.1 What Is Your Existing Annual Premium?
£ An entry is required. Invalid format.

7.2 Who Is Your Current Insurance Company?
An entry is required. Invalid format.

7.3 Who Is Your Current Insurance Broker?
An entry is required. Invalid format.

7.4 How Many Years Have You Been With Your Current Brokers?
An entry is required. Invalid format. years

7.5 What Is Your Intention This Year?
An entry is required. Invalid format.

7.6 Have You Asked All Brokers Providing Quotations To Do So By A Certain Date?
Yes No Please make a selection.

If So, Please Confirm That Date Here
A date is required. Invalid format.


Declaration

I/we declare that the foregoing statements and particulars are true and complete and I/we have disclosed all material facts and that this Proposal shall form the basis of the contract between me/us and the Insurers.
Please tick box to confirm.
I/we agree that if any information has been given by any other person other than me/us or if any part of this Proposal has been completed by any person other than me/us that person is my/our agent for that purpose.
Please tick box to confirm.
I/we agree to accept a policy of insurance subject to the terms and conditions of the Insurers policy/policies and that the Insurance(s) will not be in force until the Proposal has been accepted by the Insurers except to extent of any official cover note which it may issue.
Please tick box to confirm.












Contractors All Risks and Combined Liability Application Form

1. General Information

Your name is required.
Minimum number of characters not met.

Position is a required.

A telephone number is required.Please enter a valid telephone number.


An email address is required.Please enter a valid email address.

A company name is required.Minimum number of characters not met.

Please select a trading status.


Please enter a valid address.
Please enter a valid address.

A postcode is required.Invalid postcode.


A postcode is required.Invalid postcode.


Please enter a business description.
Please enter a business description.


A value is required.Please enter a valid number of years at premises.Please enter a valid number of years at premises.


Please describe other interested parties.
Please describe other interested parties.

A date is required.Invalid date.

2. Combined Liability Information

2.1 Limit Of Liability
Employers Liability:
£ 10,000,000

(A) Public Liability:
£ An entry is required. Invalid format.

(B) Products Liability:
£ An entry is required. Invalid format.

2.2 Claims In Last 5 Years
An entry is required.


3. Height/Depth Work Information:

Maximum Height
Meters
Maximum Depth
Meters

0-10 Meters
%
0-1 Meters
%

10-15 Meters
%
1-2 Meters
%

15-20 Meters
%
2-3 Meters
%

Above 20 Meters
%
Below 3 Meters
%


4. Estimates/Projections For The Next 12 Months:

a
Number of Persons
Wages

Clerical and Administrative
Invalid format.
£ Invalid format.

Directors/Partners Non Manual
Invalid format.
£ Invalid format.

Directors/Partners Manual
Invalid format.
£ Invalid format.

Site Supervisory & Managerial
Invalid format.
£ Invalid format.

Direct Manual PAYE
Invalid format.
£ Invalid format.

Payments to Labour Only Sub Contractors
Invalid format.
£ Invalid format.

Others (Please specify type)
Invalid format.
£ Invalid format.

Drivers (If applicable)
Invalid format.
£ Invalid format.

Payments to BFSC including supply of own materials
Invalid format.
£ Invalid format.

Elsewhere
United Kingdom

Estimated Annual Turnover
£ Invalid format.
£ Invalid format.

Cost of Materials and Sales
£ Invalid format.
£ Invalid format.

5. Works Profile

5.1 Private And Domestic
An entry is required. Invalid format. %

5.2 Shops/Offices
An entry is required. Invalid format. %

5.3 Schools/Colleges
An entry is required. Invalid format. %

5.4 Health Centers/Hospitals
An entry is required. Invalid format. %

5.5 Industrial Units
An entry is required. Invalid format. %

5.6 Agricultural Units
An entry is required. Invalid format. %

5.7 Other
An entry is required. Invalid format. %

5.8 New Build
An entry is required. Invalid format. % Of Turnover

5.9 Heat Work Away
An entry is required. Invalid format. % Of Turnover

6. Additional Information

6.1 When Was The Business Established?
A date is required. Invalid format.

6.2 Do You Operate From Your Own Premises?
Yes No Please make a selection.

6.3 Are You Members Of Any Federations Or Industry Bodies?
Yes No Please make a selection.

If So, Details Please

Please describe other interested parties.
Please describe other interested parties.

6.4 Are You CITB Registered?
Yes No Please make a selection.

6.5 Do You Have A Health & Safety Policy In Force?
Yes No Please make a selection.

6.6 If So, Do You Have An Appointed Health & Safety Officer?
Yes No Please make a selection.

6.7 If Yes, What Is The Name Of The Person?
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6.8 Is Your Health & Safety Programme Audited Externally?
Yes No Please make a selection.

6.9 Do You Provide Health & Safety Training?
Yes No Please make a selection.

6.10 Is There A Formal Safety Training Plan For Employees?
Yes No Please make a selection.

6.11 Is There An Ongoing Training Program?
Yes No Please make a selection.

6.12 Are Risk Assessments Undertaken And Recorded?
Yes No Please make a selection.

6.13 Are Method Statements Prepared For Each Contract?
Yes No Please make a selection.

6.14 Do All Employees Undertake An Induction Prior To Employment?
Yes No Please make a selection.

6.15 Are All Employees Provided With Personal Protective Equipment?
Yes No Please make a selection.

6.16 When BFSC Are Used, Do You Check Adequate Insurance Is In Place?
Yes No Please make a selection.

6.17 If You Use Heat Applications Do You Obtain A Hot Work Permit?
Yes No Please make a selection.

6.18 Do You Work In Any Hazardous Locations (I.E. Demolition Sites, Airports)
Yes No Please make a selection.

6.19 Do You Handle Asbestos In Any Way?
Yes No Please make a selection.

If So, Details Please:

Please describe other interested parties.
Please describe other interested parties.

7. Marketing Assistance

7.1 What Is Your Existing Annual Premium?
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7.2 Who Is Your Current Insurance Company?
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7.3 Who Is Your Current Insurance Broker?
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7.4 How Many Years Have You Been With Your Current Brokers?
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7.5 What Is Your Intention This Year?
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7.6 Have You Asked All Brokers Providing Quotations To Do So By A Certain Date?
Yes No Please make a selection.

If So, Please Confirm That Date Here
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8. Contractors All Risks Information

8.1 Estimated Annual Turnover:
£ A value is required.
Invalid format, please enter a number.

8.2 Maximum Anticipated Contract Value Any One Contract:
£ A value is required.
Invalid format, please enter a number.

8.3 Average Value Any One Contract:
£ A value is required.
Invalid format, please enter a number.

8.4 Maximum Duration Any One Contract:
Months A value is required.
Invalid format, please enter a number.

8.5 Average Duration Any One Contract:
Months A value is required.
Invalid format, please enter a number.

8.6 Maintenance Period Required Any One Contract (Usually 12 Months):
Months A value is required.
Invalid format, please enter a number.

8.7 Total Sum Insured Required On Own Plant:
£ A value is required.
Invalid format, please enter a number.

8.8 Maximum Value Any One Item Own Plant:
£ A value is required.
Invalid format, please enter a number.

8.9 Maximum Value Any One Item Of Plant Hired In:
£ A value is required.
Invalid format, please enter a number.

8.10 Estimated Annual Charges For Plant Hired In:
£ A value is required.
Invalid format, please enter a number.

8.11 Is Plant Hired In Under Cpa Conditions Or Similar?
Yes No Please make a selection.

8.12 Type Of Plant Hired In:

8.13 Do You Hire Plant Out?
Yes No Please make a selection.

8.14 If So, Do Cpa Conditions Apply?
Yes No Please make a selection.

8.15 Is Cover Required For Employees Tools?
Yes No Please make a selection.

8.16 If So:
A) Maximum Sum Insured Any One Employee
£ A value is required.
Invalid format, please enter a number.

B) Number Of Employees
A value is required.
Invalid format, please enter a number.

8.17 Are You Familiar With The Joint Code Of Practice For Fire Prevention On Contract Sites?
Yes No Please make a selection.

8.18 Is Smoking Restricted To Designated Site Areas Only?
Yes No Please make a selection.

9. Does Your Site Safety And Security Arrangements Include:

9.1 Storage Of Materials
Yes No Please make a selection.

9.2 Control Of Access/Egress To Site By Visitors
Yes No Please make a selection.

9.3 Full Site Perimeter Fencing And Boarding
Yes No Please make a selection.

9.4 Special Arrangements For Securing Valuable And Portable Equipment Outside Of Working Hours
Yes No Please make a selection.

9.5 Are Larger Items Of Plant Coded, Security Marked Or Fitted With Tracking Devices?
Yes No Please make a selection.

9.6 Is Plant Registered With A Scheme? E.G. The Equipment Register
Yes No Please make a selection.

9.7 Are You Citb Registered?
Yes No Please make a selection.

9.8 Are You Iso 9001 Or Similar Accredited?
Yes No Please make a selection.

9.9 Are You Members Of Any Trade Association?
Yes No Please make a selection.

If You Answered YES to 9.9 Please Give Details:

9.10 Do You Undertake Any Work Offshore Or Outside Of The Uk? If So, Please Give Details:

9.11 Please Summarise Below Your 5 Year Claims History:
An answer is required.

Declaration

I/we declare that the foregoing statements and particulars are true and complete and I/we have disclosed all material facts and that this Proposal shall form the basis of the contract between me/us and the Insurers.
Please tick box to confirm.
I/we agree that if any information has been given by any other person other than me/us or if any part of this Proposal has been completed by any person other than me/us that person is my/our agent for that purpose.
Please tick box to confirm.
I/we agree to accept a policy of insurance subject to the terms and conditions of the Insurers policy/policies and that the Insurance(s) will not be in force until the Proposal has been accepted by the Insurers except to extent of any official cover note which it may issue.
Please tick box to confirm.













There are several other classes of insurance available where insurers generally do require forms to be completed before a quotation can be provided, and these include Professional Indemnity, JCT 21.2.1 and Performance Bonds. Please contact us to outline any particular request you may have.

Contact Us
Contact Us

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Telephone:
01702 209520

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Fax:
01702 543728

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Address:
Genesis House
14-16 South Street
Rochford
Essex
SS4 1BQ

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Email:

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Online Enquiry:
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