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Residential Property Quote

For insurance of: holiday homes, holiday home lets, second homes,
let properties, unoccupied properties, student lets and DSS lets...



Please enter the clients name here:
Please enter your broker details and the name of the person you would like us to contact with the quote.
Title First Name
Last Name organisation
Work Phone Street Address
Home Phone Address (cont.)
FAX City
E-mail Postal Code

 

Property Details

Enter the address of the property to be insured (including Post Code):
Is the property divided into bedsits: (i.e. cooking facilities in the bedrooms):  Yes
No		 Please select the option which describes how your property is occupied: A. Holiday Home
B. Holiday Home Let
C. Second Home
D. Let Property
E. Student Let
F. DSS Let
G. Unoccupied Property
If the property is unoccupied, is it undergoing any refurbishment or renovation?  Yes
No		 If yes, please provide details of works:
If the property is unoccupied, state your intentions for this property in the next 12 months:
Has the property ever been used for commercial purposes (i.e. shop or office): Yes
No		 If yes, please provide details:
Is the property let to one person or family (i.e. not multi-tenure)? Yes
No		 If No, please provide details:
Is the tenancy agreement between yourself and the tenant only?  Yes
No		 If No, please provide details:
What is the approximate age of the property?  
Please select which best describes the type of property:

A. Detached
B. Semi Detached
C. Terraced
D. Bungalow
E. Flat
 in a converted property: Yes No
self contained with its own lockable entrance? Yes No
purpose built: Yes No
 F. Other (specify) 
Is the property listed or of historic value? Yes
No		 If Yes, please provide details:
Please state when you would like the cover to begin (start date): 
Please indicate the Buildings Sum to be insured:
Please state any mortgage or other financial institution that requires to be named on the policy:

CONTENTS sum insured: 
Is the property to be insured built or standard construction (i.e. brick, stone or concrete and roofed with state, tiles, concrete or asphalt)?  Yes
No		 If No, please give details:
Is the property in good state of repair and will be maintained as such: Yes
No		 If No, please provide details:
Is the property free from flooding and not in an area susceptible to flooding: Yes
No		 If no, please provide detail:
Is the property free from signs of damage due to subsidence, landslip or heave and not in an area where there has been or is evidence of these causes: Yes
No		 If No, please provide details:
Is the property being monitored for subsidence, landslip or heave, or has it ever been: Yes
No		 If Yes, please provide details:
Is the property neighbouring a property which has been subject to occurrence of subsidence, landslip or heave: Yes
No		 If Yes, please provide details:
Has the property been extended in the last 25 years: Yes
No		 If Yes, please provide details:
Is the property within 20 feet of any tree or shrub over 10 foot tall: Yes
No		 If Yes, please provide details:
Does any part of the property have a flat roof: Yes
No		 If Yes, please provide details including approximate percentage:
Does the property have boarded windows or doors? Yes
No 		If Yes Give Details:
Has any insurer declined to accept, cancelled, refused to continue or agree to continue only on special terms, any insurance for the proposer or any other person to whom this insurance would apply: Yes
No		 If Yes, please provide details:
Have you or any other person whose property is to be insured hereunder sustained any loss or damage in the last five years which would have been covered by this type of insurance had it been in force, whether or not a claim was paid: Yes
No		 If Yes, please provide details:
Have you or any person residing with you ever been convicted of arson or any criminal offence: Yes
No		 If Yes, please provide details:
       
Current Insurer?
Expiry Date?
How long have you owned the propert for?


 
 

OUR CONTACT DETAILS

Andrew Copeland
Insurance Consultants Ltd
230/234 Portland Road,
London SE25 4SL
Tel: 020 8656 2544
Fax: 020 8655 1271
info@acopeland.com

INSURANCE SPECIALISTS
Insurance Specialists
With years of experience behind us, Andrew Copeland Insurance Consultants Ltd are your one stop shop for property insurance.


Andrew Copeland Insurance Consultants Ltd is authorised and regulated by
the Financial Services Authority

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