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Contractors Proposal Form

Please fill out the following as accurately as possible.

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Please enter your first name.

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Please fill out contact details for each partner below...

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Please enter your first name.

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Please let us know about your business

If you undertake more than one activity type in your business please select secondary and tertiary options and let us know the percentages

For example Builder 70% Groundworker 30%

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Occasionally we send out useful information or requests for information to either help you grow your business or to enable us to serve you better. We keep emails to a minimum and only send out specific content related to your business.

Please ensure all answers provided are correct and accurate before submitting for a quote. Should you have any questions or require any assistance contact our brokers on 01702 225 440 - Primo plc Professional Insurance Advice

Your Insurance Requirements

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Public Liability

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Turnover Details

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Please provide a breakdown of your turnover below
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Employers Liability

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Employers’ liability insurance is a legal requirement if you employ any of the following: Full-time - part-time employees / Self-employed contractors you hire / Temporary staff, apprentices and volunteers / People taking part in work experience or training schemes

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NUMBER OF PERSONS REQUIRING COVER

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Please ensure all answers provided are correct and accurate before submitting for a quote. Should you have any questions or require any assistance contact our brokers on 01702 225 440 - Primo plc

Activity Specific Questions

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What percentage of your work is carried out at the following locations?

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Depth, Height & Heat Work

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Heat Work

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Please ensure all answers provided are correct and accurate before submitting for a quote. Should you have any questions or require any assistance contact our brokers on 01702 225 440 - Primo plc

Health and Safety & Risk Details

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Claims History

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Have you or any partner or director:

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--- IMPORTANT ---

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If unsure please seek professional advice and/or forward a copy of the contract terms to Primo plc for consideration, as some conditions may have been applied that could nullify the cover you are applying for.

Material Facts

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Copyright Primo Plc 2018 | All Rights Reserved

Primo plc is registered in England and Wales, Reg No 1008700 at Cumberland House, Baxter Avenue, Southend-on-Sea, Essex SS2 6HZ
Tel: +44 (0)1702 225400

Primo Plc is authorised and regulated by the Financial Conduct Authority.

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