N.B.  We regret we are not able to offer quotes for tree surgeons.  Cover excludes lopping, topping or felling of trees, any pruning of trees, shrubs or bushes over 3 metres, the use of explosives or crop spraying

Name of Company      

Address of Company

Post Code                     

Nature of business     Sole Trader Partnership Limited Company Other      

Trade or Occupation 

Public Liability
Indemnity required      5 million 2 million 1 million

Number of Partners, Principals or Directors 
not engaged in manual work

Number of Partners, Principals or Directors 
engaged in manual work

Number of manual worker employees             
(including sub contractors) 
excluding Partners, Principals or Directors                               

Number of clerical employees                             
excluding Partners, Principals or Directors  

Additional cover required:            Employer's Liability        All Risks on Tools       
(Public Liability cover is mandatory)          Stock in Trade       Personal Accident    
                                                                                            Professional Indemnity  
    
                   

Please confirm that the following statement is correct

I/We have experience in the type of work to which this request for a quotation relates.
I/We have not been involved in any incidents in the last five years which did give or could have given rise to a claim of a type which this insurance is intended to cover.
I/We do not use woodworking machinery, other than handheld portable power tools.
I/We do not use oxy-acetylene or similar equipment.
I/We do not work below 1 metre or above 22 metres height.
I/We do not come into contact with explosives, gases, toxic or corrosive chemicals, radioactive substances, asbestos or silica.
I/We do not undertake underpinning

I/We confirm that the above statements are true

Date from which you need cover to start (dd/mm/yyyy)    

Please enter below any further information that you think we should know  before preparing your quotation.

Tell us how to get in touch with you:

Please contact me as soon as possible regarding this matter.

Your initial quote, plus details of the extra cover you have requested will be sent to you by email or fax

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Copyright © 1999 [Harvington Underwriting Ltd]. All rights reserved.
Revised: June 19, 2008 .