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Client Details
Name		Email
Address	Please enter full details	Contact Number
Type of Business		When Established
Convictions	Please enter full details	Previous Claims	Please enter full details
Construction Questions
Type of Roof	Select Slate Tile Flat Concreate Flat Metal Flat Wooden	Type of Walls	Select Brick Stone Concreate Metal Other
Floor Construction	Select Wood Concreate	Claim free Years	Select 0 1 2 3 4 5 5+
Cover Required Questions
Building Sum £
Subsidence Cover	Yes No
Trade Stock		Fixtures& Fittings
Tobacco		Wines & Spirits
Beers/Lagers		DVD's / Games
Annual Turnover
Security Questions
5 Lever Mortise Lock	Select No Yes	Intruder Alarm	Select None NACOSS (Bells Only) NACOSS (Digital Comunicator) NACOSS (Recare) Other
Roller Shutters	Select No Yes	is the Alarm Maintained (Annual Contract)	Select No Yes
Metal Bars / Grills	Select No Yes	Level 1 Police Response	Select No Yes

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