Property Owners
Proposers Name
Management Company Name (If Applicable)
Postal Address
Street Address
Street Address Line 2
Town
County
Eircode
Risk Address
Street Address
Street Address Line 2
Town
County
Eircode
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Renewal/Inception Date
-
Day
-
Month
Year
Date
Business Description
Occupancy Split
Number of Units
Occupied As
Apartments
1
2
3
4
5
6
7
8
9
10
Family
Couple
Students
Air B&B
Unoccupied
Cafe
Retail Unit
Not Listed
Shop/Offices
1
2
3
4
5
6
7
8
9
10
Family
Couple
Students
Air B&B
Unoccupied
Cafe
Retail Unit
Not Listed
Property Section
Total Sums Insured
Building Sums Insured
Contents
Contents in a common area
Construction/Fire Precautions
Construction Type
Floor
Walls
Roof
Number of Storys
Any Flat Roof if so what %
Property Owners Liability
€2,6000,000
€6,500,000
Employers Liability (property repairs)
€13,000,000
Any Claims in the last 5 Years
1
2
3
4
5
If Yes Please provide details
How Did You Hear About Us
Referral
Google Search
Existing Client
Submit
Should be Empty: