Cottagesure Insurance Quotation Form |
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| Contact Name:* |  |
| Name of Establishment:* | |
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| Address line 1:* | |
| Address line 2:* | |
| Town or city:* | |
| Postcode:* | |
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| Daytime Contact Number:* | |
| Fax Number: | |
| Mobile Number: | |
| Email Address: | |
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Holiday Cottage Complex |
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| Business Description:* | |
| No. of letting units: | |
| Renewal Date: | |
| Current Insurer: | |
| Annual Premium: £ | |
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General Information |
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| Are the buildings constructed other than of brick, stone or concrete and roofed with slates, tiles, concrete, metal or asbestos sheeting? | |
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| Do you offer Bed and Breakfast or other facilities? | |
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| Have you sustained any loss or damage in the last 5 years? | |
| If you have answered 'YES' to any of the above questions, please supply full details: | |
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Owners Residence Information |
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| Owners Residence (if different address from above:) | |
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| Age of Applicant (there are age discounts to sections of this policy):* | |
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| Is the residence a separate building to the holiday letting units? | |
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| Are the buildings constructed other than of brick, stone or concrete and roofed with slates, tiles, concrete, metal or asbestos sheeting? | |
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| Have you sustained any loss or damage in the last 5 years? | |
| If you have answered 'YES' to any of the above questions, please supply full details: | |
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Property to be Insured |
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Holiday Cottage Complex |
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| Buildings:£* | |
| Contents:£* | |
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Owners Residence |
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| Buildings:£* | |
Contents Breakdown |
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| General:£ | |
| Antiques, Paintings and Collectables:£ | |
| Jewellery:£ | |
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| Total Contents:£* | |
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Loss of Revenue £150,000* (12 month indemnity period) |
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* Standard sum insured may be increased if required |
