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Risk Details
Year Business Established	e.g. 1983
Type of Cuisine	-
Number of Covers
Age of Property (Years)

Material Damage
Buildings	£
Wines & Spirits	£
Tobacco, Cigars	£
All other Stock	£
All Trade Contents	£
Frozen Stock Value	£

Cash Limits
Cash held in Safe outside of Business hours	£
Cash NOT in Safe outside business hours	£
Cash held at Private Residence of Assured	£
Cash, any other loss	£
Business Interruption
Estimated Gross Annual Revenue	£
Indemnity Period Required	Months

Are the premises:
Built of brick, stone, slate or tile and in a good state of repair ?	Yes No
Free from signs of damage due to subsidence, landslip or heave ? (eg. such as internal or external cracks)	Yes No
Occupied 24 Hours per day ?	Yes No
Are all external doors fitted with key operated security bolts ?	Yes No
Are all accessible windows fitted with security bolts ?	Yes No
Do you have an alarm system fitted ?	Yes No
If so, What type ? Eg. Bells only, Central Station, Redcare	-
Do you have at least two fire extinguishers installed ?	Yes No
If so, are they maintained under contract ?	Yes No
Do you provide live entertainment ?	Yes No

Declaration:
Has any insurer ever declined your proposal ?	Yes No
Has any Insurer invited renewal at an increased premium or imposed special terms ?	Yes No
Have you within the last five years, suffered any losses (whether insured or not) in respect of any risk to which this proposal relates ?	Yes No
If Yes, please give details	-
Has the proposer, or any partner or director ever been convicted of, or charged with, arson, fraud, theft or any other offence involving dishonesty of any kind?	Yes No
Have you ever had a Liquor License revoked or is there any matter outstanding for the same ?	Yes No
Are you now insured for any of the cover required ?	Yes No
If Yes, please state name of current Insurers ?
If Yes, what is the Renewal Date ?	(In "dd /mm /yyyy" format eg. Xmas is 25 /12 /1998)
What is the Renewal Premium ?	£