FLC Insurance Services
FLC Insurance Services Ltd is one of
the leading company in UK. We are 
committed to provide our customers 
with best advice. We deal in 
Commercial insurance, personal 
insurance, property insurance and 
Vehicle insurance.

Tel: 020 8542 6999
 
Shops, Cafe & Retailers
 
Pesonal Information
For What Date is the Insurance Required
Title
First Name
Surname
Business (Company) Name/Trading Name
 
Business Address
Email Address
Daytime Telephone No.
Mobile Telephon No.
What is the Legal Status of Business?
Is there a secondary trade or Occupation

Please Note: There is no need to specify a second trade unless work is undertaken that is distinct or separate the main trade and you need it to be covered by this policy

When was the business established?
How long have you held a responsible position working in this trade
 Years   Months
Losses      
Have you had any losses or incidents that have or could have given rise to claims in the last 3 years
 Yes No
       
Details
       
Premises (Retailers)
Does the security at the premises meet the Minimum Standards of Security
 Yes No
Is there are an intruder alarm fitted to the premises which is in working order and is under your client's control
 Yes No
In approximately what year were the premises built?
Where is the premises located
If the Buildings are listed or subject to a Building Preservation Notice, please specify the nature of the listing
   
Are the Premises located in an area with a history of flooding
 Yes No
Are the premises heated solely by fixed systems?
 Yes No
What are the floors constructed of
Are the premises occupied overnight by the Propprietor or a responsible employee
 Yes No
Are your premises of Standard Construction built of brick, stone or concrete and roofed entirely with slates, tiles, metal or concrete?
 Yes No
Approximately what percentage of the roof is flat?
Is the premises protected by any of the follwoing
Closed Circuit TV?
 Yes No
24 hour site security?
 Yes No
Do you use deep fat frying equipment at the premises
 Yes No    
       
Security (Retailers)
Cigraettes, cigars, and tobacco: (£)
Wines and Spirit: (£)
Video Taps, DVDs, CDs: (£)
Radio, TV, Audio & Video equipment: (£)
Computers, Computer Equipment & Games: (£)
Jewellery, Watches, Precious Metals & Stones: (£)
Cameras, Binoculars, & Photographic Equipment: (£)
Mobile Phones & Equipment: (£)
Prescription Drugs: (£)
   
       
All other stock not included in High Risk Stock entered above
All other stock in Trade: (£)
Customer goods in your custdy and control: (£)
Contents
Trade, Fixtures and Fittings: (£)
 
Please state total value of computers and Electroninc Business Equipment included within the Trade Fixtures and Fittings: (£)
All othe Contents: (£)
   
Buildings
Is cover for Buildings required?: (£)
Wines and Spirit: (£)
Other
Tenant's Improvements: (£)
Shop Fronts including glass, blinds and fittings: (£)
Business Interruption
Gross Profit: (£)
Maximum Indemnity Period: (£)
Account Receivable : (£)
   
Liability
Public and Products Liability: (£)
Maximum Indemnity Period: (£)
Working Away
Does the business undertake any work at customer or third party premises other than the delivery and collection of goods sold by the business?
 Yes No
Business Money
Money in Transit, In a bank night safe and Money in the Premises during business hours:
Optional Extensions (Retailers)
Is Subsidenc Cover Required?
 Yes No
Is cover required for business equipment whilst away from the premises?
 Yes No
Are the premises to be insured License to sell alcohol?
 Yes No
Is cover required for Theft by Employees? The limit of cover for this additional cover is restricted to £ 50,000 in respect of any one period of insurance
 Yes No
Is cover required for Terrorism?
 Yes No    
       
 
 
 
 
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the leading company in UK. We are 
committed to provide our customers 
with best advice. We deal in 
Commercial insurance, personal 
insurance, property insurance and 
Vehicle insurance.
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