Block of Flats Insurance Quotation
Wise Insurance Services Limited
30 South Parade
Mollison Way
Edgware
Middlesex
HA8 5QL
020 8905 6000
INSURED DETAILS
Name:
Property Address:
Post Code:
Telephone:
Email:
Fax:
BUILDING DETAILS
Construction Type:
Age of Building:
Listed:
Yes
No
Details if listed:
Purpose Built:
Yes
No
Number of flats:
Number of blocks:
Number of floors:
Details of occupation:
Please select
Owner Occupier
DSS
Students
Other - specify other
Details if other:
CLAIMS OR LOSSES IN LAST 3 YEARS
Claim 1
Claim date:
Claim type:
Amount settled:
Claim 2
Claim 3
COVER REQUIRED
Rebuilding Sum Insured:
Has the property or others in the immediate vicinity suffered from or is there evidence of damage by Subsidence, Heave, Landslip or Flood?:
Yes
No
Has any insurer ever declined to insure, refused to renew, terminated cover or required special terms?:
Yes
No
Any additional information you consider relevant to this risk?:
Cover Start Date:
