SB19 SUPPLIER HIRED IN EQUIPMENT INSURANCE FORM
Supplier's Business Entity, e.g Ltd Company
*
Supplier Point of Contact
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Supplier Equipment Information
Type of Goods/Equipment, e.g PA and Lighting
*
Description of Equipment
*
Total Replacement Value of Kit
*
Required Insurance Start Date (from when the hire has been agreed to start)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Required Insurance End Date (from when the hire has been agreed to end)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you supplying a single piece of equipment worth £250,000 or more?
*
Yes
No
Submit
Should be Empty: