DETAILS : |
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Contact Name: |
Number of Years Trading: |
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Description of Business/Trade: |
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Address & Postcode: |
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Company Status: |
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Contact
Telephone: |
Mobile
Number: |
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| Email
Address: |
Fax
Number: |
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| How
do you wish us to contact you? |
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COVER REQUIRED:
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Public Liability: |
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| Employers' Liability: |
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| Number of manual principals: |
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| Number of manual staff: |
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| Number of clerical staff: |
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| Annual Wageroll manual: |
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Annual turnover clerical:
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| Total Annual Turnover: |
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| Number of Vehicles: |
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| Any claims in the last 5 years? |
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| If yes, please state approximate dates, causes of claim and amounts paid |
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| Number of years experience: |
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| Tools Cover required: |
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| (Please note that cover between the hours of 9pm – 6am is not operative unless tools are placed in a locked compound or taken to your place of residence) |
| Current Insurer: |
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| Renewal Date / Start Date: |
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| Renewal Premium: |
£
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