Liability Insurance for Ex-Offenders

INSURABLE :: Insurance Solutions for Ex-Offenders

Liability Insurance Quote

Where did you hear about us?
If other please specify:
PLEASE NOTE *** We cannot offer terms for convictions of a sexual nature involving minors *** (including illegal download/possession of indecent images)
Company Details
Company Status
Company/Trading Name
First Name
Surname
Full Address
Postcode
Email Address
Telephone Number
About Your Convictions	(please list 1,2,3 in each section if you have more than 1 conviction)
Date of Offence
Date of Conviction
Type of Conviction (e.g GBH, Common Assault)
Sentence given by court (e.g. 5 years custodial or 100 hrs community service)
Sentence actually served (e.g. served 2 years then 3 months on tag)
Description of Incident (Please give as much information as possible)
Mitigating Circumstance (e.g. had drink problem at time now recovering alcoholic etc.)
Trade Description	List up to 3 trades from drop menus - if there are more than 3 trades OR you carry out any trades which are not listed please type them in box underneath
Trade 1
Traqde 2
Trade 3
Additional/ unlisted Trades
Do you use Heat? If so please give details
Is there a maximum Height Limit? Is so please give details
Do you work solely on Private Dwellings, Shops, Offices, Public Houses and Hotels?
Cover Details
Public Liability Level of Indemnity
Do you require Employers Liability?
No. of Manual Principals, Partners or Directors
No. of Manual employees or labour only sub-contractors
No. of Non-Manual Principals, Partners/ Directors
No. of Non-Manual employees
Do your payments to Bone Fide sub contractors exceed 25% of your annual turnover?
Do you require Tools cover?
If so what level of cover?
Do you require a quote for Contractors All Risk cover?	If so - we will contact you seperately for quotation.
Experience
How many full years have you been trading?
How many years experience do you have in the trade?
Claim Details
Please give FULL details of any claims made within the last 5 Years

Current renewal premium, if applicable
Current Insurer, if applicable
Additional Information
Please add any information you feel may affect the quotation.

‘Insurable’ is a trading name of Gothic Insurance Brokers Ltd who are are authorised & regulated by the Financial Services Authority, Firm Number 300031
Registered Trading address : Gothic House, Station Road, Old Harlow, Essex, CM17 0AP