Insurance Partnership quotation request

 Copyright Insurance Partnership
Please insure all details provided are accurate and correct.  Your quotation will be based on information you provide us with. Once received your request will be looked into, and one of our insurance advisers will contact you.

Tele:- 02837524000

Fax:- 02837524843

info@insurancepartnership.com

 


 
Household Quotation form            
  Personal Details      
  Proposers Title    
  Proposers Forename    
  Proposers Surname    
  Proposers Date of Birth    
  Proposers Occupation  
  Proposers Business Type    
  Marital Status    
         
  Joint Applicant Details      
  Title    
  Forename    
  Surname    
  Date Of Birth  
  Occupation    
  Business Type    
  Maritial Status    
  Relationship to Proposer    
       
  Property Details

 

      
  Post Code   *(Please provide correct Northern Ireland Post Code)
  House Type   *(Please provide correct house type... Semi detached etc...)
  Roof Type   Roof Flat
  Build Type  
  Bedroom Amount  
  Rooms/Floors    
  Year Built    
  Residence   (Do you live in the property?)
  Unoccupancy    
  Adults/Children    
  Accommodation   Any Further details?
Is smoke Alarm Fitted    
  Windows Locks Fitted   (Key operated?)  
  Property Extended   What year  
  Any Smokers    
         
  Policy Details      
  Buildings Cover Type    
  Sum Insured    
  Previous Insurance Held   If Yes, Previous Insurance Details including years insured etc.  
         
  Contents Cover Type    
  Sum Insured    
  Previous Insurance Held   If Yes, Previous Insurance Details including years insured etc.  
  Extra Cover

 

      
  All Risks   If Yes, Please provide details of any articles of value that you want covered away from home    
(Engagement rings, digital camera pedal cycles etc.)
  Unspecified effects   Please specify amount - single article limit £1500
     
  Claims History      
  Any Claims History   If Yes, Please provide details of claim dates and detail what claims were for.  
       
  Cover Start Date    
       
  Contact Details      
  Telephone Number   *  
  Email Address   *  
   

* Details required for quotation request to be completed.