Welcome to Becks Insurance Brokers, Brighton’s trusted partner for comprehensive commercial insurance solutions. We understand that every business is unique, and that’s why we offer customised insurance options to fit your specific needs and budget.

Please enable JavaScript in your browser to complete this form. – Step 1 of 17What date would you like your cover to start?Business name including trading namesLegal trading statusCompany Registration NumberIn which year did start the business?

Address

Address Line 1Address Line 2CityState / Province / RegionPostal CodeCountry

Your Name *

FirstLast

Save and Resume LaterEmail *Mobile PhoneWhat is your company website address?

Do you currently have insurance in place?

Do you have a business premises?

How many years experience do you have in your trade?

Are you exempt from holding a HM Revenue & Customs Employer`s PAYE Reference Number?

What is your HM Revenue & Customs Employer`s PAYE Reference Number?How would you best describe the business activitiesSave and Resume Later

Select any of the following that apply to any proposer, director or partner of the Trade or Business or its Subsidiary Companies if they have ever, either personally or in any business capacity

Provide further details on the advertsities noted above

In the last 5 years have you sustained any loss or had any claims made against you, whether insured or not, or are you aware of incidents that might result in a loss or claim?

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Property Cover Requested

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Would you like to insure your loss of income should there be property damage at your premises?

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Loss of Licence

Liquor Licence
Environmental Licence
Premises Licence

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Select the groups of works you engage or employ

Principals/Directors – ManualPrincipals/Directors – ClericalTemp / Perm / LOSCs – ClericalTemp / Perm / LOSCs – ManualPayments to BFSCs

Do you check and retain BFSCs insurance documents annually at their renewal? Ensuring they have the same level or more cover then you?

Number of Volunteers / Unpaid workersSave and Resume LaterMaximum depth worked to in metresMaximum height worked to in metresNumber of staffNumber of LOSCsNumber of Principals / DirectorsSave and Resume Later

Do you trade or provide services in any other territories?

UK Only
EU
USA/Canada
Rest of World

UK Sales Income / TurnoverEU Sales Income / TurnoverUSA/Canada Sales IncomeRest of World Sales Income / TurnoverValue of assets in the USA (£)% of Assets in the USANet profit in the last financial yearSave and Resume Later

From where do you import finished goods?

Value of finished goods imported directly from the EUValue of finished goods imported directly from the Far EastValue of finished goods imported directly from the USA/CanadaValue of finished goods imported directly from Australasia and the Indian Sub ContinentValue of finished goods imported from Rest of WorldSave and Resume Later

Do you send or recieve any goods by third party carrier or in your own vehicles?

Own Vehciles
Third Parties Vehicles (Couriers)

Number of vehiclesEstimated annual sendings within UKVehicle limit (£)Items being transportedNumber of claim free yearsTotal value of annual sendings (£) (Outside UK)Third Party Consignment Limit (£)Invoice Value UK to/from Western EuropeInvoice Value UK to/from North AmericaInvoice Value UK to/from Middle EastInvoice Value UK to/from Eastern EuropeInvoice Value UK to/from Far East, Australasia, Indian Sub ContinentInvoice Value UK to/from Rest of WorldInvoice Value World to World (Not entered or left UK)Save and Resume Later

Select all of the following that apply to any proposer/director/partner of the business/practice

Please confirm that the business does not operate in any of the following sectors

Directors & Officers Indemnity LimitRetroactive date (If Applicable)Enter the date that you first purchased this cover otherwise past work will not be covered.
Retroactive date
A retroactive date, also known as a retroactive inception date or retroactive cover date, refers to the specific date from which a management insurance policy provides coverage for claims arising from past actions performed by the insured.

Do you require any of these additional covers?

Employment Practice Liability
Pension Trustee Liability
Corporate Liability

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Do you provide a service, designs or give advice?

Professional Indemnity – Indemnity Limit

Cover basis

In the aggregate
Each and every claim

Largest contract valuePI Retroactive date (If Applicable) Enter the date that you first purchased this cover otherwise past work will not be covered.
Retroactive date
A retroactive date, also known as a retroactive inception date or retroactive cover date, refers to the specific date from which a management insurance policy provides coverage for claims arising from past actions performed by the insured.

Do you verify the professional indemnity insurance cover of all subcontractors?

Policy wording requiredSave and Resume Later

Are there any redundancies planned in the next 12 months?

Please provide further details

Preferred cover limit

£50,000
£100,000
£250,000

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Do you work in the construction sector and require CAR, Contract Works or Contractors All Risks?

Largest contract value next 12 monthsMaximum Limit required for Any One Contract Site:Maximum Contract Period (months)Average Contract Period (months)Total Value of Owned PlantMax value of any one item of aowned plant

Is any of the insureds own plant hired to third parties?

Please specify under what hiring conditions?

CPA
Non-CPA

Total estimate of annual hire chargesTotal Value of any on item of hired-in plant

Please specify the hiring conditions?

CPA
Non-CPA

Save and Resume LaterSignatureThe following assumptions have been made and will form the basis of the quote provided. Any incorrect declaration can affect your claim or policy.
For the property to be insured:
You are not aware of any previous flooding at the premises, whether or not it was insured and whether or not a claim was made
The property is of standard construction (walls built only of brick, stone or concrete, and roofed with only slates, tiles or concrete with no external cladding/external wall insulation)
The property does not have an Automatic Teller Machine (ATM) on site
The property is not a listed building
The business complies with the requirements of the Regulatory Reform (Fire Safety) Order 2005 or the equivalent legislation in Scotland and Northern Ireland
Based on the knowledge of any senior management and anyone involved in arranging the insurance after making a reasonable search, has any proposer (as a company or individual including any decision makers involved in how the business’s activities are to be managed or organised), director or partner of the business (or of its subsidiary companies not otherwise excluded), either personally or in any business capacity:
been declared bankrupt or been the subject of bankruptcy proceedings, an Administrative Receivership, a Company or Partnership or Individual Voluntary Arrangement, a Debt Relief Order, an Administration Order, a Compulsory Liquidation, a Creditors’ Voluntary Liquidation, a Winding Up Order or any equivalents in Scotland or Northern Ireland in the last 5 years
had a policy voided in the last 5 years
had a renewal declined in the last 5 years
had an insurance cancelled where a cancellation clause has been invoked in the last 5 years
had special terms imposed by an insurer in the last 5 years
ever been charged with (but not yet tried) or convicted of any criminal offences excluding motoring offences and offences that are spent under the Rehabilitation of Offenders Act 1974 and subsequent amendments to that Act
had a county court judgment or Scottish equivalent awarded against them in the last 5 yearsSave and Resume Later
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Copyright © Business Insurance Brokers Ltd t/as Becks (and/or) BIB (996862) is an Appointed Representative of Gauntlet Risk Management Ltd who are authorised and regulated by the Financial Conduct Authority (308081). Companies House (14167357) registered office address is Queensbury House, Queens Road, Brighton, BN1 3XF.