Unoccupied Buildings Proposal Form
1. Name of Proposer and Trading Title (if any)
2. Your Address
 Post Code
 
3. Address of the premises to which this Insurance will apply
 Post Code
 
 
4. If you are not the owner please indicate interest
5. Proposer's Business Description
 
6. Describe the premises:
  (i) Are they:
House
Flat
Shop
Office
Industrial
  Other (please describe)
  
 
  (ii) Are they:
Terraced
Semi-Detached
Detached
  (iii) Number of Floors
  (iv) Approx. age
  (v) Approx. size
  (vi) Are the premises Grade Listed?
Yes  No
If so, please state which Grade
7. State Construction:
(a) External walls of the building
(b) Roof
(c) Floors
(d) Are there areas of non-standard construction (e.g. Flat Roofs), if so please describe:-
(e) What percentage of the construction is non-standard?
%