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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 *
Please Select
Other
Recruitment Consultants Employment Agency and Labour Supplier
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
No
Insurance start date *
Are you currently an APSCo Member *
Yes
No
Cover Required
Please select the limits you require
Employers Liability *
Please Select
£10,000,000
Public and Products Liability *
Please Select
£2,000,000
£5,000,000
£10,000,000
Professional Indemnity
Please Select
Not Required
£2,000,000
£5,000,000
£10,000,000
Medical Malpractice *
Yes
No
Drivers Negligence Limit Required
Please Select
Not Required
£10,000
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
No
Do you have any Non-Standard Contracts? *
Yes
No
Do you trade outside of the UK? *
Yes
No
Do you intend to trade in the USA or Canada? *
Yes
No
Type of Work
Please provide more detail on the types of Work you engage in
Do you trade as a Contractor *
Yes
No
Do you provide Complete Teams *
Yes
No
Do you provide Managed Services *
Yes
No
Do you provide Recruitment Process Outsourcing *
Yes
No
Are there any other business activities that are relevant to underwriters *
Yes
No
Does any contract work involve Tunnelling *
Yes
No
Do you check that Personal Service Companies (PSC's) Hold PL, EL & PI insurance *
Yes
No
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
No
Claims Information
Have you had any claims or notifications in last 5 years *
Yes
No
Please check your inputs. Additional information is required.
Please check your inputs. Additional information is required.
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