EBCS

Applicant's/Contact Details

Name on quote *

Client Name / Developer(Legal Entity) *

Contact Name *

Email Address *

Landline Number

Mobile Number

Contact Address (Legal Entity)

1st Line Address *

Town/Village *

Post Code *

Company Registration Number *

Construction Project Details

Development Address

1st Line *

Town/Village *

Post Code *

Build Stage *

Construction Start Date *

Construction Finish Date *

Phased build information *

Who is carrying out Building Control? *

Contractor (brief summary of relevant experience) *

Architect (Qualifications) *

Developer (Relevant Experience Summary) *

Is SPV or recently set up company please provide information on directors' experience, parent company and their respective directors' experience

Property Details

Details of Construction Type (Timber frame; partial timber frame; block; concrete frame; stone etc) *

Details of Units

(or send over schedule of accommodation clearly stating the below)

Number of Units *

Total area of building (M/sq) *

Area of communal areas (M/sq - if applicable)

Number of stories (if applicable)

Number of blocks and breakdown of units in each block (if applicable)

Basements *

Detailed Property Types (Select all that apply) *

Site Layout (Showing site numbering and number of units) *

Cost of Construction of property(ies) *

Rebuild Cost (Reinstatement Value) *

If Conversion:

Age of existing building

Type of construction (Steel frame; Concrete frame etc)

Value of existing Building

Is the project a vertical extension?

Yes

No

Please Note: A Structural Report will be necessary to issue a quote.

Please ensure that Supporting Information has been uploaded in Stage 1 above (where applicable):

Structural Engineer Reports (for Convn's/Renov/Refurb's/Exten's etc)

Condition Report (for Convn's/Renov/Refurb's/Exten's etc)

Scope of Works

Drawings

BBA Certificates

Trade Certificates

Piling Certificates

OtherOther

Other information needed for final Certificate Sign Off:

1) Insurance Backed Guarantee (Flat roof and habitable basements)
2) Structural Engineers Sign Off and the Structural Engineers Report

Declaration

1a) We declare that to the best of our knowledge and believe that the statements and particulars supplied are true and complete.
1b) We declare that no material information has been withheld.
2) We agree to accept the usual form of policy for this type of insurance. A specimen copy of the policy is available on request.

We understand that Insurers, (Credit Reference Agencies and other Information Agencies) share information with each other, with regard to credit agreements, policies and claims, primarily to help assess risks, handle and prevent claims. We consent to this.

I agree with the statements above *

Yes

Position of Signatory *

Date *

DATA PROTECTION ACT

We may use the personal and business details you give us, or which are supplied by third parties, to provide you with a quotation, to administer your policy, to search the les of credit reference agencies who may keep a record of the search, to carry out such nancial and other enquiries as we consider necessary to evaluate the risk and assist in making a decision regarding our acceptance of
the risk, to support the development of our business including your details in customer surveys, and for market research and compliance business reviews. We may also share these details with other insurance organisations to help off- set risks, to help administer your policy and to handle claims and prevent fraud. We will store your details on computer but will not keep them for longer than necessary. Under the terms of the Data Protection Act 1998, you are entitled to a copy of all the information we hold about you.

Please refer to our Privacy Policy for details of compliance with data protection regulations

Form Security

Request a Quote

Step 1 – Upload any of the following documents which you may have:

Step 2 – Application Form