Name
Trading Title
Address
		Postcode
Telephone		E-Mail Address
Business	-Choose- Other - Specify Below Public House Wine Bar Bar
Unlisted Business
Who else occupies the property?		-Choose- Shop - Proposer lives on premises Shop- Employee Lives on Premises Shop - Manager Lives on Premises Lock up Shop Lock up shop with dwelling upstairs
Date Business Established
Premises Details
-Walls- Brick Brick/Steel Steel Wood Concrete Other -Roof- Slate Steel Concrete Timber/Felt Other -Floors- Concrete Stone Wood Other ATM/Cash Machine No ATM Cash Machine Yes-inside premises Yes-outside premises
-Heating- Gas CH Electric Oil Portable Heaters None -Electrics Checked- Less than 12 months Less than 3 years Less than 5 Years Other Shop Front Protection Roller Shutters External Grilles Internal Grilles None
Accessible Window Protection Grilles and Window Locks Window Locks Internal Grilles None -Intruder Alarm- NACOSS Approved BT Redcare SSAIB Approved BT Redcare NACOSS Approved Digital Commmunicator SSAIB Approved Digital Communicator Bells Only Alarm Other Alarm None
Childrens Play Area No Yes -Food Please Choose- No Food Sandwiches and Cold Snacks Bar Meals No Deep Fat Frying Bar Meals inc Deep Fat Frying Full Restaurant Facilities
-Accomodation Please Choose- None 1 Guest Bedroom 2 Guest Bedrooms 3 Guest Bedrooms 4 Guest Bedrooms Entertainment None Live Acts Bands etc Entertainment - with entrance fee
Sums Insured
Buildings		£ full rebuilding cost.
Landlords Fixtures and Fittings		£
Tenants Improvements		£
Stock excluding items below		£
Wines and Spirits		£
Cigarettes and Tobacco		£
Shop Fronts and Fascia		£includes neon signs
All Other Contents		£business equipment
Electronic Business Machines		£Tills, computers etc
Business Interruption		£12 months Gross Profit
Loss of Money	Cash in Transit £Cash in Safe £
Frozen Foods Cover		Choose Yes No	£
Goods in Transit		Choose Yes No	Please Select £1,000 £2,500 £5,000
Loss of Licence		Choose Yes No	£
Claims in the Last Three Years		Yes No
Claims details of any
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