Fillable Contractors All Risks Insurance Proposal Form (JCT Insurance)

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Contractors All Risks Insurance Proposal Form (JCT Insurance)

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The Contractors All Risks Insurance Proposal Form (JCT Insurance) form is 2 pages long and contains:

  • 1 signature
  • 4 check-boxes
  • 24 other fields

Country of origin: UK
File type: PDF

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Contractors “All Risks” Insurance Proposal Form
1. Please provide details of your estimates for the forthcoming year:
Maximum contract period (months)
Average contract period (months)
Projected turnover for the forthcoming 12 month period
£
Maximum contract price
£
New replacement value of plant and equipment
£
Current market value of all plant and equipment
£
Projected hiring charges for the forthcoming 12 month period
£
Value of hand-held tools
£
Number of properties working on at any one time
The average value of each premises
£
2. Have you ever had any insurance or proposal cancelled, withdrawn, declined or made subject to special
terms?
YES NO
If YES, please provide full details
Proposers Details
Name of Insured/Proposer
Business Name
Address
Postcode
Phone
Email Address
Web address
Please provide a description of your Business
Contractors “All Risks” Insurance Proposal Form
3. Has any claim, or are you aware of any circumstances that may give rise to a claim, whether successful or
not been made against you or your predecessors in business or any past or present principal, partner,
director or employee (whether insured or not)?
YES NO
If YES, please provide full details:
__________________________________________________________________________________________
SIGNING THIS PROPOSAL DOES NOT BIND THE PROPOSER TO COMPLETE THIS INSURANCE
Declaration
I/We declare that the statements and particulars in this proposal are true and that no material facts have been
misstated or suppressed after enquiry. I agree that this proposal, together with any other information supplied
shall form the basis of any contract of insurance effected thereon. I undertake to inform the insurers of any
material alteration to those facts occurring before the completion of the contract of insurance.
Signed…………………………………………………………….
Title………………………………………………………………..
(to be signed by Partner, Director or Principal or equivalent)
Firm(s)……………………………………………………………
Date………………………………………………………………
www.asisltd.co.uk www.piexpert.co.uk enquiries@asisltd.co.uk
(01825) 745 419 (01825) 761 479
Authorised and regulated by the Financial Conduct Authority Registered in England No 3565404
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Contractors All Risks Insurance Proposal Form (JCT Insurance)

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Completed 10 June 2021

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