New Quotation Request

Proposer Information

Provide proposer and client details

What is the proposer name *

Trading name (if diffferent)

Proposer address line 1 *

Proposer address line 2

Proposer address line 3 *

Proposer address line 4

Country *

Postcode *

Contact name *

Contact Phone Number *

Contact Email *

Website *

Business description *

The proposer accepts the Acceptance Criteria *

Provide the date your business was established *

What is your HMRC Employer Reference Number *

Does your business have any subsidiaries *

Yes

Insurance start date *

Cover Required

Please select the limits you require

Employers Liability *

Public and Products Liability *

Professional Indemnity

Medical Malpractice *

Yes

Drivers Negligence Limit Required

What is your projected turnover *

What is your actual turnover for last financial year

What is your projected wage roll including directors *

Temporary Assignments

Provide wageroll for Temporary Assignments

Where engaged by you on a contract of service

PSC Off-Payroll / Outside IR35

Personnel supplied under standard terms and conditions

What is the wageroll for Direct Contract Work

What fees to do you generate from Permanent Placements

What fees to do you generate from other sources

Temporary Wageroll

What Percentage of your Temporary Payroll is from the following sectors

Do you supply Temporary Personnel *

Yes

Do you have any Non-Standard Contracts? *

Yes

Do you trade outside of the UK? *

Yes

Do you intend to trade in the USA or Canada? *

Yes

Type of Work

Please provide more detail on the types of Work you engage in

Do you trade as a Contractor *

Yes

Do you provide Complete Teams *

Yes

Do you provide Managed Services *

Yes

Do you provide Recruitment Process Outsourcing *

Yes

Are there any other business activities that are relevant to underwriters *

Yes

Does any contract work involve Tunnelling *

Yes

Do you check that Personal Service Companies (PSC's) Hold PL, EL & PI insurance *

Yes

Indemnification

To provide this indemnity, please outline details of the contracts and whether indemnity is supplied to you or by you.

Do you need to provide indemnity to any third parties *

Yes

Claims Information

Have you had any claims or notifications in last 5 years *

Yes

Please check your inputs. Additional information is required.