{"id":2924,"date":"2012-05-14T12:04:02","date_gmt":"2012-05-14T11:04:02","guid":{"rendered":"https:\/\/www.emberjd.com\/?p=2924"},"modified":"2020-07-27T13:50:40","modified_gmt":"2020-07-27T12:50:40","slug":"home-with-lodgers","status":"publish","type":"post","link":"https:\/\/www.emberjd.com\/what-we-insure\/home-with-lodgers\/","title":{"rendered":"Home With Lodgers"},"content":{"rendered":"<p><script type=\"text\/javascript\">\/\/ <![CDATA[\nfunction MM_validateForm() { \/\/v4.0\n  if (document.getElementById){\n    var i,p,q,nm,test,num,min,max,errors='',args=MM_validateForm.arguments;\n    for (i=0; i<(args.length-2); i+=3) { test=args[i+2]; val=document.getElementById(args[i]);\n      if (val) { nm=val.name; if ((val=val.value)!=\"\") {\n        if (test.indexOf('isEmail')!=-1) { p=val.indexOf('@');\n          if (p<1 || p==(val.length-1)) errors+='- '+nm+' must contain an e-mail address.\\n';\n        } else if (test!='R') { num = parseFloat(val);\n          if (isNaN(val)) errors+='- '+nm+' must contain a number.\\n';\n          if (test.indexOf('inRange') != -1) { p=test.indexOf(':');\n            min=test.substring(8,p); max=test.substring(p+1);\n            if (num<min || max<num) errors+='- '+nm+' must contain a number between '+min+' and '+max+'.\\n';       } } } else if (test.charAt(0) == 'R') errors += '- '+nm+' is required.\\n'; }     } if (errors) alert('The following error(s) occurred:\\n'+errors);     document.MM_returnValue = (errors == ''); } }\n\/\/ ]]><\/script><\/p>\n<h3>Fill in the form below for a Home Insurance with Lodgers quote<\/h3>\n<p><a href=\"javascript:;\" onClick=\"window.open('important-quote-information','myWin','scrollbars=yes,width=590,height=400');\">Important please read<\/a>, click on each tab below and carefully answer the questions<\/p>\n<form id=\"home\" class=\"unoccupied\" action=\"https:\/\/www.emberjd.com\/sendformhomewithlodgers.php\" method=\"post\">\n<div id=\"TabbedPanels1\" class=\"TabbedPanels\">\n<ul class=\"TabbedPanelsTabGroup\">\n<li class=\"TabbedPanelsTab\">Start<\/li>\n<li class=\"TabbedPanelsTab\">About You<\/li>\n<li class=\"TabbedPanelsTab\">Contact<\/li>\n<li class=\"TabbedPanelsTab\">The Property<\/li>\n<li class=\"TabbedPanelsTab\">Buildings<\/li>\n<li class=\"TabbedPanelsTab\">Contents<\/li>\n<li class=\"TabbedPanelsTab\">Security<\/li>\n<li class=\"TabbedPanelsTab\">Final Details<\/li>\n<li class=\"TabbedPanelsTab\">Submit for Quote<\/li>\n<\/ul>\n<div class=\"TabbedPanelsContentGroup\">\n<div class=\"TabbedPanelsContent\">\n<h3>General details<a href=\"javascript:;\" onClick=\"window.open('occupancy','myWin','scrollbars=yes,width=590,height=420');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a><\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Renewal date \/ Cover date?<\/p>\n<\/td>\n<td><span id=\"sprytextfield1\"><\/p>\n<p><input id=\"HOME_WITH_LODGERS_coverdate\" class=\"textinput\" name=\"HOME_WITH_LODGERS_coverdate\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldMinCharsMsg\">Looks too short for a date &#8211; e.g. 30\/01\/2009<\/span><span class=\"textfieldMaxCharsMsg\">Looks too long for a date e.g. 30\/01\/2009<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Where did you hear about us?<\/p>\n<\/td>\n<td><span id=\"sprytextfield2\"><\/p>\n<p><input id=\"Source\" class=\"textinput\" name=\"Source\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">We need to know this.<\/span><span class=\"textfieldMinCharsMsg\">We need a little bit more than that&#8221;<\/span><span class=\"textfieldMaxCharsMsg\">That&#8217;s slightly too much text<\/span><\/p>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Occupancy<\/p>\n<\/td>\n<td><select id=\"OCCUPANCY\" class=\"textselectbox\" name=\"OCCUPANCY\"><option selected=\"selected\">Main occupied residence shared with lodger(s)<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Number of occupants, excluding lodgers?<\/span><\/p>\n<\/td>\n<td><select id=\"Number_occupants_excluding_lodgers\" class=\"textselectbox\" name=\"Number_occupants_excluding_lodgers\"><option selected=\"selected\">1<\/option><option>2<\/option><option>3 or more<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td height=\"30\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Maximum number lodgers in your home?<\/p>\n<\/td>\n<td><select id=\"Maximum_number_lodgers\" class=\"textselectbox\" name=\"Maximum_number_lodgers\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6 or more cannot quote\">6 or more cannot quote<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Any of your lodgers students under 25?<\/p>\n<\/td>\n<td><select id=\"Any_of_your_lodgers_students_over_25\" class=\"textselectbox\" name=\"Any_of_your_lodgers_students_under_25\"><option selected=\"selected\">No<\/option><option>Yes<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">About You <\/span>tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Enter your details as policyholder, option to include spouse or partner as joint policyholder<a href=\"javascript:;\" onClick=\"window.open('occupation','myWin','scrollbars=yes,width=590,height=360');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a><\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Title?<\/p>\n<\/td>\n<td colspan=\"3\"><select id=\"Title\" class=\"textselectbox\" name=\"Title\"><option selected=\"selected\">Mr<\/option><option>Mrs<\/option><option>Miss<\/option><option>Ms<\/option><option>Dr<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">First name?<\/p>\n<\/td>\n<td colspan=\"3\"><span id=\"sprytextfield3\"><\/p>\n<p><input id=\"First_name\" name=\"First_name\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">We need to know this detail.<\/span><span class=\"textfieldMinCharsMsg\">Your name is longer than this!<\/span><span class=\"textfieldMaxCharsMsg\">That&#8217;s too long for a name!<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Surname?<\/p>\n<\/td>\n<td colspan=\"3\"><span id=\"sprytextfield4\"><\/p>\n<p><input id=\"Surname\" name=\"Surname\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">We need to know this detail.<\/span><span class=\"textfieldMinCharsMsg\">Your name is longer than this!<\/span><span class=\"textfieldMaxCharsMsg\">That&#8217;s too long for a name!<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Date of Birth?<\/p>\n<\/td>\n<td width=\"52\"><select id=\"dobday\" class=\"textselectbox\" name=\"dobday\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><option value=\"12\">12<\/option><option value=\"13\">13<\/option><option value=\"14\">14<\/option><option value=\"15\">15<\/option><option value=\"16\">16<\/option><option value=\"17\">17<\/option><option value=\"18\">18<\/option><option value=\"19\">19<\/option><option value=\"20\">20<\/option><option value=\"21\">21<\/option><option value=\"22\">22<\/option><option value=\"23\">23<\/option><option value=\"24\">24<\/option><option value=\"25\">25<\/option><option value=\"26\">26<\/option><option value=\"27\">27<\/option><option value=\"28\">28<\/option><option value=\"29\">29<\/option><option value=\"30\">30<\/option><option value=\"31\">31<\/option><\/select><\/td>\n<td width=\"64\"><select id=\"dobmonth\" class=\"textselectbox\" name=\"dobmonth\"><option value=\"Jan\">Jan<\/option><option value=\"Feb\">Feb<\/option><option value=\"March\">Mar<\/option><option value=\"April\">Apr<\/option><option value=\"May\">May<\/option><option value=\"June\">June<\/option><option value=\"July\">July<\/option><option value=\"August\">Aug<\/option><option value=\"September\">Sept<\/option><option value=\"October\">Oct<\/option><option value=\"November\">Nov<\/option><option value=\"December\">Dec<\/option><\/select><\/td>\n<td width=\"206\"><select id=\"dobyear\" class=\"textselectbox\" name=\"dobyear\"><option selected=\"selected\" value=\"2015\">2015<\/option><option value=\"1998\">1998<\/option><option value=\"1997\">1997<\/option><option value=\"1996\">1996<\/option><option value=\"1995\">1995<\/option><option value=\"1994\">1994<\/option><option value=\"1993\">1993<\/option><option value=\"1992\">1992<\/option><option value=\"1991\">1991<\/option><option value=\"1990\">1990<\/option><option value=\"1989\">1989<\/option><option value=\"1988\">1988<\/option><option value=\"1987\">1987<\/option><option value=\"1986\">1986<\/option><option value=\"1985\">1985<\/option><option value=\"1984\">1984<\/option><option value=\"1983\">1983<\/option><option value=\"1982\">1982<\/option><option value=\"1981\">1981<\/option><option value=\"1980\">1980<\/option><option value=\"1979\">1979<\/option><option value=\"1978\">1978<\/option><option value=\"1977\">1977<\/option><option value=\"1976\">1976<\/option><option value=\"1975\">1975<\/option><option value=\"1974\">1974<\/option><option value=\"1973\">1973<\/option><option value=\"1972\">1972<\/option><option value=\"1971\">1971<\/option><option value=\"1970\">1970<\/option><option value=\"1969\">1969<\/option><option value=\"1968\">1968<\/option><option value=\"1967\">1967<\/option><option value=\"1966\">1966<\/option><option value=\"1965\">1965<\/option><option value=\"1964\">1964<\/option><option value=\"1963\">1963<\/option><option value=\"1962\">1962<\/option><option value=\"1961\">1961<\/option><option value=\"1960\">1960<\/option><option value=\"1959\">1959<\/option><option value=\"1958\">1958<\/option><option value=\"1957\">1957<\/option><option value=\"1956\">1956<\/option><option value=\"1955\">1955<\/option><option value=\"1954\">1954<\/option><option value=\"1953\">1953<\/option><option value=\"1952\">1952<\/option><option value=\"1951\">1951<\/option><option value=\"1950\">1950<\/option><option value=\"1949\">1949<\/option><option value=\"1948\">1948<\/option><option value=\"1947\">1947<\/option><option value=\"1946\">1946<\/option><option value=\"1945\">1945<\/option><option value=\"1944\">1944<\/option><option value=\"1943\">1943<\/option><option value=\"1942\">1942<\/option><option value=\"1941\">1941<\/option><option value=\"1940\">1940<\/option><option value=\"1939\">1939<\/option><option value=\"1938\">1938<\/option><option value=\"1937\">1937<\/option><option value=\"1936\">1936<\/option><option value=\"1934\">1934<\/option><option value=\"1933\">1933<\/option><option value=\"1932\">1932<\/option><option value=\"1931\">1931<\/option><option value=\"1930\">1930<\/option><option value=\"1929\">1929<\/option><option value=\"1928\">1928<\/option><option value=\"1927\">1927<\/option><option value=\"1926\">1926<\/option><option value=\"1925\">1925<\/option><option value=\"1924\">1924<\/option><option value=\"1923\">1923<\/option><option value=\"1922\">1922<\/option><option value=\"1921\">1921<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Occupation and type of business?<\/p>\n<\/td>\n<td colspan=\"3\"><span id=\"sprytextfield11\"><br \/>\n\t<input id=\"Occupation\" class=\"textinput\" name=\"Occupation\" type=\"text\" \/><strong>* <\/strong><br \/>\n\t<span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Title? (only complete to add a spouse or partner)<\/p>\n<\/td>\n<td colspan=\"3\"><select id=\"Spouse-or_partner\" class=\"textselectbox\" name=\"Spouse_or_partner\"><option>Mr<\/option><option selected=\"selected\">Mrs<\/option><option>Miss<\/option><option>Ms<\/option><option>Dr<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">First name?<\/p>\n<\/td>\n<td colspan=\"3\"><input id=\"Firstname2\" name=\"Firstname2\" type=\"text\" value=\"None\" \/><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Surname?<\/p>\n<\/td>\n<td colspan=\"3\"><input id=\"surname2\" name=\"surname2\" type=\"text\" value=\"None\" \/><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Date of Birth?<\/p>\n<\/td>\n<td width=\"52\" align=\"left\" valign=\"middle\"><select id=\"dobday2\" class=\"textselectbox\" name=\"dobday2\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><option value=\"12\">12<\/option><option value=\"13\">13<\/option><option value=\"14\">14<\/option><option value=\"15\">15<\/option><option value=\"16\">16<\/option><option value=\"17\">17<\/option><option value=\"18\">18<\/option><option value=\"19\">19<\/option><option value=\"20\">20<\/option><option value=\"21\">21<\/option><option value=\"22\">22<\/option><option value=\"23\">23<\/option><option value=\"24\">24<\/option><option value=\"25\">25<\/option><option value=\"26\">26<\/option><option value=\"27\">27<\/option><option value=\"28\">28<\/option><option value=\"29\">29<\/option><option value=\"30\">30<\/option><option value=\"31\">31<\/option><\/select><\/td>\n<td width=\"64\" align=\"left\" valign=\"middle\"><select id=\"dobmonth2\" class=\"textselectbox\" name=\"dobmonth2\"><option value=\"ja\">Jan<\/option><option value=\"f\">Feb<\/option><option value=\"mar\">Mar<\/option><option value=\"ap\">Apr<\/option><option value=\"may\">May<\/option><option value=\"jun\">June<\/option><option value=\"jul\">July<\/option><option value=\"au\">Aug<\/option><option value=\"s\">Sep<\/option><option value=\"o\">Oct<\/option><option value=\"n\">Nov<\/option><option value=\"d\">Dec<\/option><\/select><\/td>\n<td width=\"206\" align=\"left\" valign=\"middle\"><select id=\"dobyear2\" class=\"textselectbox\" name=\"dobyear2\"><option selected=\"selected\" value=\"2015\">2015<\/option><option value=\"1998\">1998<\/option><option value=\"1997\">1997<\/option><option value=\"1996\">1996<\/option><option value=\"1995\">1995<\/option><option value=\"1994\">1994<\/option><option value=\"1993\">1993<\/option><option value=\"1992\">1992<\/option><option value=\"1991\">1991<\/option><option value=\"1990\">1990<\/option><option value=\"1989\">1989<\/option><option value=\"1988\">1988<\/option><option value=\"1987\">1987<\/option><option value=\"1986\">1986<\/option><option value=\"1985\">1985<\/option><option value=\"1984\">1984<\/option><option value=\"1983\">1983<\/option><option value=\"1982\">1982<\/option><option value=\"1981\">1981<\/option><option value=\"1980\">1980<\/option><option value=\"1979\">1979<\/option><option value=\"1978\">1978<\/option><option value=\"1977\">1977<\/option><option value=\"1976\">1976<\/option><option value=\"1975\">1975<\/option><option value=\"1974\">1974<\/option><option value=\"1973\">1973<\/option><option value=\"1972\">1972<\/option><option value=\"1971\">1971<\/option><option value=\"1970\">1970<\/option><option value=\"1969\">1969<\/option><option value=\"1968\">1968<\/option><option value=\"1967\">1967<\/option><option value=\"1966\">1966<\/option><option value=\"1965\">1965<\/option><option value=\"1964\">1964<\/option><option value=\"1963\">1963<\/option><option value=\"1962\">1962<\/option><option value=\"1961\">1961<\/option><option value=\"1960\">1960<\/option><option value=\"1959\">1959<\/option><option value=\"1958\">1958<\/option><option value=\"1957\">1957<\/option><option value=\"1956\">1956<\/option><option value=\"1955\">1955<\/option><option value=\"1954\">1954<\/option><option value=\"1953\">1953<\/option><option value=\"1952\">1952<\/option><option value=\"1951\">1951<\/option><option value=\"1950\">1950<\/option><option value=\"1949\">1949<\/option><option value=\"1948\">1948<\/option><option value=\"1947\">1947<\/option><option value=\"1946\">1946<\/option><option value=\"1945\">1945<\/option><option value=\"1944\">1944<\/option><option value=\"1943\">1943<\/option><option value=\"1942\">1942<\/option><option value=\"1941\">1941<\/option><option value=\"1940\">1940<\/option><option value=\"1939\">1939<\/option><option value=\"1938\">1938<\/option><option value=\"1937\">1937<\/option><option value=\"1936\">1936<\/option><option value=\"1934\">1934<\/option><option value=\"1933\">1933<\/option><option value=\"1932\">1932<\/option><option value=\"1931\">1931<\/option><option value=\"1930\">1930<\/option><option value=\"1929\">1929<\/option><option value=\"1928\">1928<\/option><option value=\"1927\">1927<\/option><option value=\"1926\">1926<\/option><option value=\"1925\">1925<\/option><option value=\"1924\">1924<\/option><option value=\"1923\">1923<\/option><option value=\"1922\">1922<\/option><option value=\"1921\">1921<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Occupation and type of business?<\/p>\n<\/td>\n<td colspan=\"3\"><input id=\"Occupation2\" class=\"textinput\" name=\"Occupation2\" type=\"text\" value=\"None\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">Contact<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Please enter your contact details, <a href=\"javascript:;\" onClick=\"window.open('contact-details','myWin','scrollbars=yes,width=590,height=400');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a>we will reply to your quote request by email<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Telephone number?<\/p>\n<\/td>\n<td><span id=\"sprytextfield6\"><\/p>\n<p><input id=\"Contact_phone_number\" class=\"textinput\" name=\"Contact_phone_number\" type=\"text\" \/><strong>*<\/strong><span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Email address?<\/p>\n<\/td>\n<td><span id=\"sprytextfield5\"><\/p>\n<p><input id=\"Contact_email_address\" class=\"textinput\" name=\"Contact_email_address\" type=\"text\" \/><strong>*<\/strong><span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldInvalidFormatMsg\">Invalid format.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">The Property<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Please enter details about the property to be insured<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">House name \/ number?<\/p>\n<\/td>\n<td colspan=\"2\"><span id=\"sprytextfield7\"><\/p>\n<p><input id=\"Insured_address_house_number\" class=\"textinput\" name=\"Insured_address_house_number\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Postcode?<\/p>\n<\/td>\n<td colspan=\"2\"><span id=\"sprytextfield8\"><\/p>\n<p><input id=\"Insured_address_postcode\" class=\"textinput\" name=\"Insured_address_postcode\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Approximate year property built?<\/p>\n<\/td>\n<td colspan=\"2\"><span id=\"sprytextfield9\"><\/p>\n<p><input id=\"Year_built\" class=\"textinput\" name=\"Year_built\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldInvalidFormatMsg\">Invalid format.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Approximate year property purchased?<\/p>\n<\/td>\n<td colspan=\"2\"><span id=\"sprytextfield10\"><\/p>\n<p><input id=\"Year_purchased\" class=\"textinput\" name=\"Year_purchased\" type=\"text\" \/> <strong>*<\/strong> <span class=\"textfieldRequiredMsg\">A value is required.<\/span><span class=\"textfieldInvalidFormatMsg\">Invalid format.<\/span><span class=\"textfieldMinCharsMsg\">Minimum number of characters not met.<\/span><span class=\"textfieldMaxCharsMsg\">Exceeded maximum number of characters.<\/span><\/p>\n<p><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Is the property?<\/p>\n<\/td>\n<td colspan=\"2\"><select id=\"Ownership_of_property\" class=\"textselectbox\" name=\"Ownership_of_property\"><option selected=\"selected\">Mortgaged<\/option><option>Owned outright<\/option><option>Rented privately<\/option><option>Council rented<\/option><option>Housing Association<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Type of property?<\/p>\n<\/td>\n<td colspan=\"2\"><select id=\"Type_of_property\" class=\"textselectbox\" name=\"Type_of_property\"><option>Detached house<\/option><option value=\"Semi detached house\">Semi detached house<\/option><option value=\"Terraced house\">Terraced house<\/option><option value=\"Detached bungalow\">Detached bungalow<\/option><option value=\"Semi detached bungalow\">Semi detached bungalow<\/option><option value=\"Terraced bungalow\">Terraced bungalow<\/option><option value=\"Maisonette\">Maisonette<\/option><option value=\"Flat, basement or ground floor\">Flat, basement or ground floor<\/option><option value=\"Flat, 1st floor or above\">Flat, 1st floor or above<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Construction of the external walls?<\/p>\n<\/td>\n<td><select id=\"Exterior_walls_construction_type\" name=\"Exterior_walls_construction_type\"><option selected=\"selected\"value=\"Brick construction\">Brick<\/option><option value=\"Render over brick\">Render over brick<\/option><option value=\"Stone\/Flint\">Stone\/Flint<\/option><option value=\"Concrete construction\">Concrete<\/option><option value=\"Timber frame with brick walls\">Timber frame with brick walls<\/option><option value=\"Timber frame with plaster panels\">Timber frame with plaster panels<\/option><option value=\"Timber frame with cedar cladding\">Timber frame with cedar cladding<\/option><option value=\"Timber\">Timber<\/option><option value=\"Wattle and daub\">Wattle and daub<\/option><option value=\"Cob\">Cob<\/option><option value=\"Prefabricated (no quote)\">Prefabricated (cannot quote)<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td class=\"formlabel\">\n<p class=\"formlabel\">Construction of the roof?<\/td>\n<td colspan=\"2\"><select id=\"Roof_construction\" name=\"Roof_construction\"><option selected=\"selected\">Tile or slate<\/option><option>Concrete<\/option><option>Zinc<\/option><option>Rubber<\/option><option>Single ply membrane<\/option><option>Felt over timber<\/option><option>Thatch (cannot quote)<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Approximate percentage of any flat roof?<\/p>\n<\/td>\n<td><select id=\"Percentage_of_flat_roof\" name=\"Percentage_of_flat_roof\"><option selected=\"selected\"value=\"0%\">0%<\/option><option value=\"5%\">Up to 5%<\/option><option value=\"Up to 10%\">Up to 10%<\/option><option value=\"Up to 20%\">Up to 20%<\/option><option value=\"Up to 30%\">Up to 30%<\/option><option value=\"Up to 40%\">Up to 40%<\/option><option value=\"Up to 50%\">Up to 50%<\/option><option value=\"100%\">100%<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Number of bedrooms?<\/p>\n<\/td>\n<td colspan=\"2\"><span id=\"sprytextfield12\"><br \/>\n<input id=\"Number_of_bedrooms\" class=\"textinput\" name=\"Number_of_bedrooms\" type=\"text\" \/><strong>*<\/strong><span class=\"textfieldRequiredMsg\">A value is required.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Is the property a listed building?<\/p>\n<\/td>\n<td colspan=\"2\"><select id=\"\" name=\"Is_the_property_listed\"><option selected=\"selected\">No<\/option><option>Yes<\/option><\/select><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">Buildings<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Buildings insurance, only select a Rebuilding sum insured <a href=\"javascript:;\" onClick=\"window.open('buildings-insurance','myWin','scrollbars=yes,width=590,height=360');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a> if cover is required<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"62%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">BUILDINGS if required select Rebuilding sum insured<\/p>\n<\/td>\n<td colspan=\"3\"><select id=\"Buildings sum insured\" class=\"textselectbox\" name=\"Buildings sum insured\"><option selected=\"selected\">Not required<\/option><option>\u00a3100,000<\/option><option>\u00a3110,000<\/option><option>\u00a3125,000<\/option><option>\u00a3150,000<\/option><option>\u00a3175,000<\/option><option>\u00a3200,000<\/option><option>\u00a3210,000<\/option><option>\u00a3225,000<\/option><option>\u00a3250,000<\/option><option>\u00a3275,000<\/option><option>\u00a3300,000<\/option><option>\u00a3310,000<\/option><option>\u00a3325,000<\/option><option>\u00a3350,000<\/option><option>\u00a3375,000<\/option><option>\u00a3400,000<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Accidental damage cover required for buildings?<\/p>\n<\/td>\n<td><select id=\"Accidental damage cover required for buildings\" name=\"Accidental damage cover required for buildings\"><option selected=\"selected\">Not required<\/option><option>Yes<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Buildings voluntary excess <span style=\"font-size: small;\">(with a premium discount)<\/span>?<\/p>\n<\/td>\n<td><select id=\"Buildings voluntary excess\" name=\"Buildings voluntary excess\"><option selected=\"selected\">Zero<\/option><option>\u00a3100<\/option>><option>\u00a3250<\/option>><option>\u00a3500<\/option><\/select><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Click on the <span style=\"text-decoration: underline;\">Contents<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Contents insurance,<a href=\"javascript:;\" onClick=\"window.open('contents-insurance','myWin','scrollbars=yes,width=590,height=545');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a> with option to also include cover away from home<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"65%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\">CONTENTS select your sum insured?<\/p>\n<td colspan=\"3\"><select id=\"Contents sum insured\" class=\"textselectbox\" name=\"Contents sum insured\"><option selected=\"selected\">\u00a320,000<\/option><option>\u00a322,500<\/option><option>\u00a325,000<\/option><option>\u00a327,500<\/option><option>\u00a330,000<\/option><option>\u00a332,500<\/option><option>\u00a335,000<\/option><option>\u00a337,500<\/option><option>\u00a340,000<\/option><option>\u00a342,500<\/option><option>\u00a345,000<\/option><option>\u00a347,500<\/option><option>\u00a350,000<\/option><option>\u00a355,000<\/option><option>\u00a360,000<\/option><\/select><\/td>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Accidental damage cover for contents?<\/p>\n<\/td>\n<td><select id=\"Accidental damage cover required for contents\" name=\"Accidental damage cover required for contents\"><option selected=\"selected\">Not required<\/option><option>Yes<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Contents voluntary excess (with a premium discount)?<\/span><\/p>\n<\/td>\n<td><select id=\"Contents voluntary excess\" name=\"Contents voluntary excess\"><option selected=\"selected\">Zero<\/option><option>\u00a3100<\/option>><option>\u00a3250<\/option>><option>\u00a3500<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">VALUABLES OVER \u00a31,500 WITHIN YOUR HOME<\/span><br \/>\n<span style=\"font-size: small;\">Gold, silver, pictures, works of art, televisions, audio &#038; home computers kept within your home only. List each single item or set <span style=\"text-decoration: underline;\">and<\/span> its new value over \u00a31,500<\/span><\/td>\n<td><textarea id=\"Valuables_over_\u00a31,500_in_home\" class=\"textarea\" cols=\"20\" rows=\"3\" name=\"Valuables_over_\u00a31,500_in_home\">Not required<\/textarea><\/td>\n<\/tr>\n<tr>\n<td width=\"60%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">UNSPECIFIED POSSESSIONS AWAY FROM HOME<\/span><br \/>\n<span style=\"font-size: small;\">If required select a sum insured<\/span><\/p>\n<\/td>\n<td colspan=\"3\"><select id=\"Unspecified_cover_away_from_home\" class=\"textselectbox\" name=\"Unspecified_cover_away_from_home\"><option selected=\"selected\">Not required<\/option><option>\u00a31,500 with single item limit of \u00a3750<\/option><option>\u00a32,000 with single item limit of \u00a31,000<\/option><option>\u00a32,500 with single item limit of \u00a31,250<\/option><option>\u00a33,000 with single item limit of \u00a31,500<\/option><\/select><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">SPECIFIED ITEMS OVER \u00a31,500 AWAY FROM HOME<\/span><br \/>\n<span style=\"font-size: small;\">Jewellery, watches, cameras, laptops &#038; hearing aids. List each single item or set <span style=\"text-decoration: underline;\">and<\/span> its new value over \u00a31,500<\/span><\/p>\n<\/td>\n<td><textarea id=\"Specified_items_away_from_home\" class=\"textarea\" cols=\"20\" rows=\"2\" name=\"Specified_items_away_from_home\">Not required<\/textarea><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">BICYCLES AWAY FROM HOME<\/span><br \/>\n<span style=\"font-size: small;\">List the make, model <span style=\"text-decoration: underline;\">and<\/span> new value of each bicycle<\/span><\/p>\n<\/td>\n<td><textarea id=\"Bicycles_away_from_home\" class=\"textarea\" cols=\"20\" rows=\"2\" name=\"Bicycles_away_from_home\">Not required<\/textarea><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">Personal Money and Cards Away from Home?<\/p>\n<\/td>\n<td><select id=\"Personal money and cards away from home\" name=\"Personal money and cards away from home\"><option selected=\"selected\">Not required<\/option><option>Yes (\u00a3500 of cover)<\/option><\/select><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">Security<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Please answer the questions regarding security <a href=\"javascript:;\" onClick=\"window.open('approved-locks','myWin','scrollbars=yes,width=590,height=545');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a>at the property<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"80%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Are all external doors fitted with 5 lever mortice deadlocks or UPVC \/ aluminium doors fitted with a multi point locking system?<\/span><\/p>\n<\/td>\n<td><select id=\"All_external_doors_fitted_with_5_lever_mortice_deadlocks_or_UPVC_or_aluminium_doors_fitted with_a_multi_point_locking_system\" class=\"textselectbox\" name=\"All_external_doors_fitted_with_5_lever_mortice_deadlocks_or_UPVC_or_aluminium_doors_fitted with_a_multi_point_locking_system\"><option>Yes<\/option><option selected=\"selected\">No<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Are all accessible windows fitted with key locks?<\/span><\/p>\n<\/td>\n<td><select id=\"All_accessible_windows_fitted_with_key_locks\" class=\"textselectbox\" name=\"All_accessible_windows_fitted_with_key_locks\"><option>Yes<\/option><option selected=\"selected\">No<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Is there a professionally installed burglar alarm, with an annual maintenance contract?<\/span><\/p>\n<\/td>\n<td><select id=\"Alarm_fitted with maintenance contract\" class=\"textselectbox\" name=\"Alarm_fitted with maintenance contract\"><option>Yes<\/option><option selected=\"selected\">No<\/option><\/select><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">If yes, alarm connected to a monitoring station?<\/span><\/p>\n<\/td>\n<td><select id=\"Alarm_connnected to monitoring station\" class=\"textselectbox\" name=\"Alarm_connected to monitoring station\"><option>Yes<\/option><option selected=\"selected\">No<\/option><\/select><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">Final Details<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>About the property, policyholder(s) or any family member living at the insured property<a href=\"javascript:;\" onClick=\"window.open('final-details','myWin','scrollbars=yes,width=590,height=400');\"><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166 lazyload\" title=\"Information\" alt=\"Information\" data-src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 10px; --smush-placeholder-aspect-ratio: 10\/15;\" \/><noscript><img decoding=\"async\" class=\"alignright size-full wp-image-1166\" title=\"Information\" alt=\"Information\" src=\"https:\/\/www.emberjd.com\/wp-content\/uploads\/2012\/02\/information symbol.jpg\" width=\"10\" height=\"15\" \/><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/noscript><\/a><\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Has the property ever been damaged by subsidence, heave or landslip, monitored for subsidence, survey reported movement, showing signs of cracking or within an area subject to subsidence? <strong>If yes<\/strong> <a href=\"https:\/\/www.emberjd.com\/what-we-insure\/heave-subsidence-underpinned\/\" title=\"Heave Subsidence Underpinned\">Click-Here<\/a><\/span><\/p>\n<\/td>\n<td><select id=\"Ever had damage_from_subsidence, heave, landslip, movement or cracks or in area subject to subsidence\" class=\"textselectbox\" name=\"Ever had damage_from_subsidence, heave, landslip, movement or cracks or in area subject to subsidence\"><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Are there any trees or shrubs over 10 metres tall within 10 metres of the property?<\/span><\/p>\n<\/td>\n<td><select id=\"obvious damage  from subsidence or cracking2\" class=\"textselectbox\" name=\"Trees or shrubs over 10 metres within 10 metres\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Has the property or the neighbouring area ever flooded or in an area at risk of flooding?<\/span><\/p>\n<\/td>\n<td><select id=\"Ever flooded or at risk of flooding\" class=\"textselectbox\" name=\"Ever flooded or at risk of flooding\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"70%\" align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Any unspent criminal conviction(s) or pending prosecution(s)?<\/span><\/p>\n<\/td>\n<td width=\"9%\"><select id=\"Unspent_criminal_convictions\" class=\"textselectbox\" name=\"Unspent_criminal_convictions\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Ever been declared bankrupt or the subject of bankruptcy proceedings?<\/span><\/p>\n<\/td>\n<td><select id=\"Bankrupt or bankruptcy proceedings\" class=\"textselectbox\" name=\"Bankrupt or bankruptcy proceedings\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Ever had an insurance proposal declined, had a policy cancelled by an insurer, renewal refused or had special terms imposed?<\/span><\/p>\n<\/td>\n<td><select id=\"Insurance refused declined cancelled or special terms applied\" class=\"textselectbox\" name=\"Insurance refused declined cancelled or special terms applied\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\"><span style=\"font-size: small;\">Made any claims under home insurance policy for this or any other property or any incidents of damage or loss not insured, in the last 5 years?<\/span><\/p>\n<\/td>\n<td><select id=\"Home insurance claims in the last 5 years\" class=\"textselectbox\" name=\"Home insurance claims in the last 5 years\"><option value=\"Yes\">Yes (give details in box below)<\/option><option selected=\"selected\" value=\"No\">No<\/option><\/select><\/td>\n<td align=\"left\"><strong>*<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\">\n<p class=\"formlabel\">\n<p class=\"formlabel\">If you have answered <strong>Yes<\/strong> to any of the questions above, please give details here.<br \/>\nFor each claim in the last 5 years we need to know: [Month\/Year], [Type of Claim] and [Cost].<\/p>\n<\/td>\n<td colspan=\"2\"><textarea id=\"textarea\" cols=\"4\" rows=\"3\" name=\"textarea2\"><\/textarea><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>Questions marked * are mandatory, click <span style=\"text-decoration: underline;\">Submit for Quote<\/span> tab above to continue<\/strong><\/p>\n<\/div>\n<div class=\"TabbedPanelsContent\">\n<h3>Click submit, we will then contact you by email as soon as we have obtained a quote<\/h3>\n<table class=\"formtable\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\" width=\"651\">\n<tbody>\n<tr>\n<td width=\"338\" align=\"center\"><input id=\"button\" name=\"button\" type=\"submit\" value=\"SUBMIT\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"mandatory\"><strong>If you remain on this page after clicking submit, please re-check the quote form by clicking on each tab. 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