Commercial Property Quote Important please read Step 1 of 5 - Start 20% StartRenewal or cover start date?* Date Format: DD slash MM slash YYYY Quotes valid for up to 30 days 💾 Save for later Please enter your details as the policyholderLet us know your interest in the property?*Freeholder (individual)Freeholder (limited company)Management companyLeaseholder (cannot quote)Will the policy be in the name of?*Individual's nameCompany nameIndividual* Mr.Mrs.MissMs.Dr.Prof.Rev. Title First name Surname Company name*Input full company nameEmail address?* Enter Email Confirm Email Telephone number?* 💾 Save for later Please enter details about the property to be insuredDo you owner occupy the property?*NoYes (cannot quote)Tenancy of the property?*OfficeOffice with flats aboveShopShop with flats aboveSurgerySurgery with flats aboveWarehouseIndustrial unitType to use search 🔍 Business tenants trade or profession?*Insured address?* - City Postcode Approximate year property built?*Approximate year property purchased?*Construction of the external walls?*BrickRender over brickStone/FlintConcreteSteel frame with asbestos cement cladding panelsSteel frame with brick wallsSteel frame with concrete wallsSteel frame with stone wallsTimber frame with brick wallsTimber frame with plaster panelsTimber frame with cedar claddingTimberWattle and daubCobPrefabricated (cannot quote)Type to use search 🔍 Construction of the roof?*Tile or slateZincRubber (EPDM)Single ply membraneFelt over timberThatch (cannot quote)Approximate percentage of any flat roof?*0%Up to 5%Up to 10%Up to 20%Up to 30%Up to 40%Up to 50%100%Total number of flats?*Total number of storeys?*Floor construction?*TimberConcreteOccupancy of the property?*Full occupiedPart occupied / part unoccupiedCompletely unoccupiedType of residential tenant?*No residential tenantsLeaseholderPrivate rentalLeasehold and private rentalPart or all holiday lets (cannot quote)Students (cannot quote)DSS claimants (cannot quote)Asylum seekers (cannot quote)Type to use search 🔍 💾 Save for later Please enter details about the buildings cover requiredRebuilding cost of the property £?*Accidental damage cover required for buildings?*Not requiredYesSubsidence cover required for buildings?*Not requiredYesLoss of rent indemnity period?*12 months24 months36 months(following insured damage)Loss of rent sum insured*(following insured damage) 💾 Save for later Has the policyholder(s) and the property to be insuredAny unspent criminal conviction(s) or pending prosecution(s)?*NoYes (give details in box below)Please give details*Ever been declared bankrupt or the subject of bankruptcy proceedings?*NoYes (give details in box below)Please give details*Ever had a proposal declined, had a policy cancelled by an insurer, renewal refused or had special terms imposed?*NoYes (give details in box below)Please give details*Has the property or the neighbouring area ever flooded or in an area at risk of flooding?*NoYes (give details in box below)Please give details*Has the property ever been damaged by subsidence, ground heave or landslip, monitored for subsidence, survey reported settlement or movement, showing signs of cracking or within an area subject to subsidence?*NoYes (give details in box below)Please give details*Are there any trees or shrubs over 10 metres tall within 10 metres of the property?NoYes (give details in box below)Please give details*Made any claims under property insurance policy for this or any other property or any incidents of damage or loss not insured, in the last 5 years?NoYes (give details in box below)Please give details*Month / YearType of Claim / Brief DescriptionCost £ (If you have had more than 2 claims in the last 3 years we cannot offer a quote)IMPORTANT INFORMATION WHICH MUST BE READ IN FULLThe information contained in this Statement of Fact forms the basis of your policy and is fundamental to the risk assumed by the Insurers. You must notify Ember JD Insurance Brokers immediately if any of the above details are incorrect as your cover might be invalidated if you do not. Misrepresentation We declare that to the best of my knowledge and belief the information I/We have provided in connection with this proposal to Ember JD Insurance Brokers, whether in my own hand or not, is true and complete and I/We have not withheld or misrepresented any information. I/We ask underwriters to act upon the information provided and issue a contract of insurance between us and I/We agree to accept underwriter’s policy terms, conditions and exclusions. I/We consent to the seeking of information from other insurers to check the answers I/We have provided and I/We authorise the giving of such information for such purposes. I/We understand that if I/We have withheld or misrepresented any of the information contained in this proposal, underwriters may be entitled to void the insurance. Data Protection Act 1998 By accepting this Statement of Fact you consent to Ember JD Insurance Brokers using the information we may hold about you for the purpose of providing insurance and handling claims, if any, and to process sensitive personal data about you where this is necessary (for example, health information or criminal convictions). This may mean we have to give some details to third parties involved in providing insurance cover. These may include insurance carriers, third party claims adjusters, fraud detection and prevention services, reinsurance companies and insurance regulatory authorities. Where such sensitive personal information relates to anyone other than you, you must obtain the explicit consent of the person to whom the information relates both to the disclosure of such information to us and its use by us as set out above. The information provided will be treated in confidence and in compliance with the Data Protection Act 1998. You have the right to apply for a copy of you information (for which we may charge a small fee) and to have any inaccuracies corrected. Basis of Cover I understand that my acceptance of this Statement of Fact does not bind me to complete the insurance but agree that, should a contract of insurance be concluded, this Statement of Fact and the statements made in it and the information provided in connection with it will be relied upon by the underwriters in deciding whether to accept this insurance. Your records You should keep a record (including copies of any letters) of all information supplied to Ember JD Insurance Brokers for the purpose of entering into this insurance. Change in Circumstance You must inform Ember JD Insurance Brokers of any change in circumstances which may affect this insurance. If you are in any doubt you should consult Ember JD Insurance Brokers. E.U. Disclosure Clause (UK) Notice to the Proposer / Insured: The parties are free to choose the law applicable to this insurance contract. Unless specifically agreed to the contrary this insurance shall be subject to English Law. Complaints Any enquiry or complaint should be addressed in the first instance to your broker, Ember JD Insurance Brokers. The process for complaining directly to Lloyds can be found in the Complaints section of your Policy Wording. The Financial Ombudsman If you are still not satisfied with the way a complaint has been dealt with you may ask The Financial Ombudsman to review your case without prejudice to your rights in law. You can contact The Financial Ombudsman at: The Financial Ombudsman Service Exchange Tower London E14 9SR Telephone: 0800 023 4567 www.financial-ombudsman.org.uk. 💾 Save for later This iframe contains the logic required to handle Ajax powered Gravity Forms.