Wardrop
& Co Insurance are please to provide Dealers Insurance, specialising
in, but not limited to, Stamp and other Philatelic content. Please complete
the form below to electronically sumbit a request for a quote. We will
contact you using the details below as soon as we can. Please print
and retain a copy of the form for your records.
Note: The signature and date only need to be filled in on a paper
copy of the form.
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| Proposer
Details: |
(Dealers
Insurance) |
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| Forename |
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| Surname |
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| Trading Name |
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| Trading Style |
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(eg
Retail, Auctioneers, Postal etc) |
| Address of Premises
to be insured: |
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| Number |
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| Street |
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| Town |
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| County |
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| Postal code |
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| Country |
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| Telephone |
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| FAX |
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| Website |
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| Mobile |
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| E-mail |
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| Premises
Details: |
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| Is the
address at which the collection is kept: |
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| Occupied
soley by you? |
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| In a
good state of repair? |
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Built
of brick, stone or concrete and roofed with slate, tiles, metal, asbestos
or concrete ?: |
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| If "no"
please provide details |
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| Are
all external doors fitted with deadlocks to BS3621 ?: |
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| Are
all accessible windows fitted with locks having removable keys? |
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If
NO or you are in doubt please give details of makes and types of locks
fitted: |
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| Are
the premises alarmed? |
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| Type
of signalling? |
(Central Station, BT Redcare or Bells only) |
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| Is the
alarm system maintained under contract? |
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| Age
of building? |
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| Which
floor(s) do you occupy? |
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| Please
give details of any other security (eg 24 Hour security gaurds, CCTV,
strong rooms or safes (with make and model)) |
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| Cover Required: |
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| Stock |
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| Stock at premises
and/or bank vault (£) |
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| Stock at exibitions,
stamp fairs and shows (£) |
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| Number
of exibitions, fairs or shows anticipated in one year |
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In
the UK
Overseas |
| Stock at any other
premises in the UK (excluding shows etc) (£) |
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| Stock while in transit
anywhere in the world (£) |
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| Estimated total
value of annual sendings (£) |
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In the
UK
Overseas |
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| Optional
Covers: |
Please
complete where required |
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| Office
Contents |
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| Value of office
contents (£) |
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| Is accidental damage
cover required? |
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| Business
interuption |
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| Loss of revenue
(12 months indeminty period) (£) |
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| Liability
Insurance |
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| Public Liability
Indeminity limit: |
£500,000 |
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| Employers Liablity
indemnity Limit: |
£10,000,000 |
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| Annual Turnover?
(£) |
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| Number of staff? |
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| Annual Wageroll?
(£) |
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| Insurance
History: |
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| Have
you ever had |
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| An application
for insurance refused? |
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| Renewal
of such insurance refused or cancelled? |
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| Increased
premium or special terms and restrictions imposed? |
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| Any
losses by any of the risks to be covered within the last five years?
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| If "Yes",
please give details |
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DECLARATION
To the best of my knowledge and belief the sums insured above represent
the full value of the property to be insured. The information provided
in connection with this proposal application, whether in my hand or not,
is true and I have not withheld any material facts.
I understand that non-disclosure or misrepresentation will entitle the
insurers to void the insurance.
I understand that the signing of the proposal/ application does not bind
me to complete the insurance but agree that should a contract of insurance
be concluded, this proposal/application and the statements made therein
shall form the basis of the contract.
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| I
agree to the above declaration:
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| Signature: |
Date: |
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The company is authorised and regulated by the Financial Services Authority. Our Registration number is 304502 and you can check this by visiting the FSA Website or telephoning them on 0845 606 1234. The Wardrop & Co privacy policy can be found here.
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