Business Insurance Quotation


Important Notice

1) To get accurate quotes, please kindly provide detail and accurate information as the accuracy of premium depend on the accuracy of information given.

2) All data or information given will be kept confidential and only use for our company data usage and quotation.

Business/Proposer's Name : *
Office / Handphone : * Fax No :   
Email Address : Contact Person : *  
Description of Business/Trade :
  Others, please Specify:
Location of Risk (Address) :
Correspondence / Billing Address :
Period of Insurance : From To
All Risk Insurance
Sum insured for Machinery/Equipment : $
Sum insured for Renovation / Furniture / Fixures&Fitting / Office Equipment & All other contents pertaining to Insured's business : $
Sum insured for Material in Trade : $ Please Specify Item:
Fire Insurance
Sum insured for Building Only : $
Sum insured for Machinery/Equipment : $
Sum insured for Renovation / Furniture / Fixures&Fitting / Office Equipment & All other contents pertaining to Insured's business : $
Sum insured for Material in Trade : $ Please Specify Item:
Burglary Insurance
Sum insured for Machinery/Equipment : $
Sum insured for Renovation / Furniture / Fixures&Fitting / Office Equipment & All other contents pertaining to Insured's business : $
Sum insured for Material in Trade : $ Please Specify Item:
 
.......................................................................................................................................................................................
 
For All Risk/Fire/Burglary Insurance, provide the following information:
1) Insured premise constructed of Brick/Tile/Conrete? If No, please specify : 
2) Insured premise solely occupied by insured? If No, please specify : 
3) Any hazardous goods stored in the premise? If Yes, please specify :
4) Insured premise protected with
Fire Alarm Sprinkler
Fire Extinguisher Hosereel
5) Insured premise protected with
Burlgary Alarm 24-hr Security guard
Solid Door/Glass Door/Gate/Shutter CCTV
Workmen Compensation
No. of Employees Annual Salary / Other Earning (12 Months) Occupation / Nature of Work
$
$
$
$
Please combine the number of employee and their total salary/earning for employees that have the same occupation category or nature of work
(E.g. No of employee - 3, Total earning $150,000 ($50,000x3), Occupation - Sales Engineers)
1) Are your workers involved in height >30 feet above ground?
2) Are your workers involved in chemical/flammable/excavation works, construction/erection/demolition of buildings/manholes
3) Do you want to insure employee for Travelling to and from work? Meal Hour
4) Are your workers involved in testing/installation/fabrication work outside office/factory premises (i.e at third party's premises)?
Public Liability
Sum insured for Any One Occurrence   $100K    $250K    $500K    $1million   Other Limit:$
Fidelity Guarantee
Sum insured $ No. of employee to be insured :
Money
Sum insured in Premise during office hr $ After office hr $ Outside premise during office hr (in Transit) $
Plate Glass
Sum insured $  
Claim History and Current Insurer
Any Claim History in 3 years?     (Claim History for any of the insurance classes)
If Yes, please provide detail :  
Currently under any insurance : If Yes, Current Insurer :
   
How You get to know about us :
Your friend/Relative/Associate Name :
 
 
   

Copyright 2005 All Solutions. All rights reserved. Credits.