Pub insurance proposal

Tell us about the pub.

This proposal form is designed for public houses, gastro pubs, pub theatres and wine bars. Please answer all questions fully and accurately.

Failure to disclose material information may invalidate insurance cover. Fields marked * are required.

Your personal details

Full name *

Date of birth

Email address *

Telephone number

Home address

Section 1 – Proposer & risk details

Inception date (the day you want the policy to start)

Please advise the type of risk *

Proposer's name in full *

Trading name in full

What is the business status? *

Company registration number

Is the client ERN exempt?

UK businesses employing one or more people need an ERN (Employer's Reference Number, or 'Employer PAYE Reference'). You'll find it on your P45, P60, P11/D and most payslips. It looks like NNN/Aznnnnn.

Is there a third party interest to be noted?

Section 2 – Risk address & trading history

Risk address *

Postcode *

Website / social media

Number of years trading at this address?

Number of years trading at a previous address?

Section 3 – Premises

The premises / buildings of the business being proposed (including outbuildings):

Have walls built of brick, stone or concrete?

Have composite panels installed, which form part of the fabric of the building?

Have a roof of slate, tile, metal or concrete excluding any flat roof area?

Flat roof %?

Have solar panels installed?

Are in a good state of repair and kept in a like manner?

Have a listed status?

Were built in what year?

Located in a mill complex?

Trade all year round?

Entirely self contained?

i.e. with a separate lockable entrance and exit

Are occupied solely by the business?

Section 4 – Sums insured

Buildings (£)

Loss of rent payable (£)

Tenants improvements (£)

Trade fixtures & fittings, machinery, plant and all other contents (£)

Electronic equipment & computers (£)

Stock (£)

Wines & spirits (£)

Tobacco, vapes, e-cigarettes & ancillary equipment (£)

Deterioration of stock (£)

Goods in transit (£)

Money in gaming machines — overall amount in all machines (£)

Number of gaming machines

Business interruption (£)

Business interruption indemnity period

Estimated annual wageroll (£)

Number of employees?

Estimated annual turnover (£)

Section 5 – Activities & trading features

Is frying undertaken at the premises, other than shallow frying?

Is a pressure cooker used at the premises?

Number of covers

Are there any guestrooms available to let?

Outside catering?

i.e. provides a catering service for third-party locations

Does the proposer hold a current and valid licence to sell alcohol on the premises and are not aware of any matters pending that are likely to affect that licence?

Entrance fee, other than at Christmas and New Year?

Door staff?

Open after 2am?

Children's play area?

ATM?

Directors / partners

Please give the name, role, date of birth, home address and contact telephone number for each director or partner.

Director / partner 1

Full name

Role / position

Date of birth

Contact telephone

Home (residential) address

Section 6 – Insurance history

Current insurer

Current premium (£)

Renewal date

Any declined or cancelled insurance?

Claims history for the last 5 years

Additional information — any other requirements or details you'd like us to know

Declaration

I/We declare that the statements and particulars contained within this proposal form are true and complete to the best of my/our knowledge and belief. I/We understand that failure to disclose material information may invalidate any insurance cover provided.

Signature (typed full name) *

Name *

Position

Date *

Supporting documents: after you submit, you can email your current policy schedule, claims history, risk survey or other documents to enquiries@gmg-insurance.co.uk quoting your reference.

We'll only use your details to prepare a quote. No marketing lists.