Pub & Wine Bar Insurance
Tel: 01992 718666
 
To obtain a quote, please complete the following, and press the "Submit Request" button at the bottom of the form. We will contact you by telephone or email with a quote.
email Address
Confirm email Address
Title
First Name
Surname
Company Name/Trading Name
Correspondence Address
  
House/Building No or Name
Street
Town
County
Post Code
Country
Contact Telephone Number
Date of Birth
Where Did You See Us Advertised
Existing Customer (Any Product)
YES NO 
Renewal Date of Current Insurance
    
Property Details
 
Same as correspondence address (If no complete details of site address)
YES NO 
Building No or Name
Street
Town
County
Post Code
Country
   
About the Premises
  
Buildings
£
Glass Cover
£
Wines/Beer/Spirits
£
Tobacco
£
Frozen Foods
£
All Other Stock
£
Fixtures/Fittings & Contents
£
Business Interruption Cover
(Loss of Gross Profit)
£
Loss of Licence Cover
£
Money Cover
£
Do You Have a Safe on the Premises?
YES NO 
Goods in Transit cover
£
Public Liability
£
Employers Liability (Standard level if required is £10,000,.000)
YES NO 
   
Security: Please advise which of the following apply:
  
Five Lever Mortise Deadlocks on All External Doors
YES NO 
Key Operated Window Locks on All Windows
YES NO 
Roller Shutters
YES NO 
Grilles
YES NO 
Bars On Windows
YES NO 
Advise which Windows
CCTV
YES NO 
CCTV Location
INTERNAL EXTERNAL BOTH

Alarm System:
Please advise type of Alarm. i.e. Bells/Audio only, Central Station, Redcare. If other please give further information.
(pressing 'enter' at the end of each line)
Claims:

Losses over the past 5 Years (Including Costs)

(pressing 'enter' at the end of each line)
Construction
  

Is your building of standard construction?
i.e. Built from the following:

  
Walls: Brick, Stone or Concrete.
YES NO 
If other, please advise further details
Roof: Slate, Tile
YES NO
If other, please advise further details
Is any of the roof flat?
YES NO 
If YES, advise % of flat area
%
If YES, advise construction of flat roof. i./e asphalt on timber or concrete
Approx Year of Build
Does this building contain any composite panels in the construction?
i.e. are any of the walls insulated with polystyrene filler.
YES NO 
Please supply some general information about your business
  
Do you have Door Security Personnel
YES NO 
Children's Play Area
YES NO 
Ticket Admissions
YES NO 
Live Entertainment or Disco etc.
YES NO 
If you have answered YES to any of the above 4 questions, we may need to contact you to obtain further information before processing your quotation. Please answer the remaining questions and ensure that you have advised a Contact Telephone Number where requested. 
Do you have a restaurant?
YES NO 
If YES, advise no of seats in restaurant
Do you have any guest rooms to let?
YES NO 
If YES, how many rooms
Is there any residential accommodation?
YES NO 
If YES, advise who lives there. i.e. proprietor/manager/family etc
Do you have a designated outside smoking area?
YES NO 
If YES, advise if you have awnings/heating etc.
Do you provide hot food
YES NO 
Is waste cleared from inside the premises daily?
YES NO 
Do you use any mobile heating units?
YES NO 
If YES, give further information
Do you have a basement?
YES NO 
If YES, advise what you store there, or other use.
 

Please add any further information you may feel is relevant to this quotation
   
Declaration: I declare that the information I have given above is true and complete. I have not withheld any material facts (see IMPORTANT NOTES.) I agree that this Quoteation Request shall form the basis of the Contract between me and Shearwater Insurance.
Shearwater Insurance Services Ltd
Registered Office: 2 Bath Place, London, EC2A 3JJ. Registered in the UK Company No: 02701633