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CIOB>CLI Quotation Form

CIOB

For more information please call 0845 305 8390 or email ciob@frd-rs.co.uk

CIOB Combined Liability Insurance

Online Quotation Form

Please complete the form below to send us an enquiry
*Denotes a required field


Client Details
Customer Name *
Legal Status*
Address Details
Address Line 1
Address Line 2
Town
County
Postcode*
Email *
Contact Tel No*
Cover
Cover Start Date (dd/mm/yyyy)
Business Information
Main Trade *
Secondary Trade *
Do you use heat? *	Yes No
Woodworking machinary in use? *	Yes No
Number of Principals and/or partners *	(Non Limited companies only)
Number of employees *
Have you been trading for 3 or more years? *	Yes No
Claims
Have you had a claim in the last 3 years? *	Yes No
Number of claims *
Total Paid and/or outstanding *
Standard Cover
Public and Products Liability indemnity limit *
Optional Extensions
Please indicate if you would like a quote for any of the following:
1. Employers Liability	Yes No
2. Do you require Working Partners extension?	Yes No
3. Include non permanent employees	Yes No
4. Tools & business equipment - sum insured per person
5. Business contents sum insured
6. Legal Expenses cover	Yes No

If you would like more information then please either contact us or use the above enquiry form.

Members of the British Insurance Brokers Association.

Fitzgerald Reid Dickinson Ltd T/A FRD Risk Solutions is authorised and regulated by the Financial Services Authority.

CIOB Insurance Services is an Introducer Appointed Representative of Fitzgerald Reid Dickinson Ltd

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