Octagon House, 18 Nash Green, Hemel Hempstead, Herts. HP3 8AA        Phone :   01442 242 400
Residential Property
 
Name:
Email :

Property :
Please enter the property postcode :
Please enter the property address :
Town / City :
County :
Is the property fully occupied? :
Yes: No
Please select the type of private dwelling :
Please state the number of flats :
Please state the material used for construction of floors :
Buildings sum insured amount? £ :
Do you require contents cover? :
Yes: No
Landlords contents sum insured amount? £ :
Contents of common parts sum insured amount? £ :
Do you require rent receivable cover? :
Yes: No
Rent sum insured amount per month? £ :

Please enter the numbers of months you require rent cover? :

Have you sustained any loss, damage, injury or disability or incurred any liability (whether insured or not) during the past 3 years in connection with your business? :
Yes: No