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Has the proposer:-

1. Ever had a proposal for insurance declined or had special terms applied by an insurer?

PLEASE SELECT —Please choose an option—YesNo

2. Ever been convicted of or charged but not tried with any offence, other than parking or speeding offences or those which are now spent under the Legal Aid, Sentencing and Punishment of Offenders Act 2012?

PLEASE SELECT —Please choose an option—YesNo

3. Ever been convicted of, or charged but not tried with any offence breach of health and safety legislation?

PLEASE SELECT —Please choose an option—YesNo

4. Ever been made subject to a County Court Judgement (or Scottish Equivalent) which remains outstanding?

PLEASE SELECT —Please choose an option—YesNo

5. Ever been declared bankrupt or insolvent or been subject of bankruptcy proceeding?

PLEASE SELECT —Please choose an option—YesNo

6. Had any loss or incident giving rise to a loss whether insured or not during the last five years?

PLEASE SELECT —Please choose an option—YesNo

Does the Micropub at the above address:-

7. Provide any hot food?

PLEASE SELECT —Please choose an option—YesNo

8. Allow any live music or entertainment?

PLEASE SELECT —Please choose an option—YesNo

9. Open for more than 12 hours and / or beyond 11pm?

PLEASE SELECT —Please choose an option—YesNo

10. Have an annual turnover exceeding £250,000 per annum?

PLEASE SELECT —Please choose an option—YesNo

11. Employ Security or Door Staff either directly or as sub-contractors?

PLEASE SELECT —Please choose an option—YesNo

Is the property to be insured:-

12. Constructed of brick, stone or concrete and the external surface of the roof constructed of slates, tiles,concrete, asphalt or of any entirely incombustible mineral ingredient other than flat roofs?

PLEASE SELECT —Please choose an option—YesNo

13. Located within 250 metres of a river, stream, tidal water or other water course and ever been flooded or any neighbouring properties ever been flooded?

PLEASE SELECT —Please choose an option—YesNo

14a. Free from signs of internal or external stepped or diagonal cracking?

PLEASE SELECT —Please choose an option—YesNo

14b. Currently being monitored for subsidence, heave or landslip?

PLEASE SELECT —Please choose an option—YesNo

14c. Within a 50 metre radius of any other Property that has been the subject of an occurrence of Subsidence, heave or Landslip?

PLEASE SELECT —Please choose an option—YesNo

15. A listed building (meaning that is appears in the Statutory List of Buildings of Special Architectural or Historic Interest)?

PLEASE SELECT —Please choose an option—YesNo

16. In a good state of repair and will be so maintained?

PLEASE SELECT —Please choose an option—YesNo

17. Heated only by fixed gas or oil central heating or fixed electric storage or convector heaters?

PLEASE SELECT —Please choose an option—YesNo

18. Protected by a level of security that conforms to a minimum of 5 lever mortice deadlocks on all entry and exit doors and / or shutters?

Minimum Standards of Physical Security

It is a condition precedent to Our liability in respect of Damage by theft or attempted

theft that the following security conditions apply:

(a) except for openings designated by the Fire Authority as fire exits, the final exit

door of the Premises must be fitted with either an operational roller shutter or a

mortise deadlock with 5 or more levers or in conformity to BS3621:1980 for thief

resistant locks used in conjunction with a matching boxed striking plate and all other

external doors and all internal doors giving access from an external source to any

part of the Premises must be fitted with either

(i) a mortise deadlock

or

(ii) 2 key operated security bolts for doors, one fitted about 30cm from the

top and the other about 30cm from the bottom of the door

(b) all ground floor and basement opening windows and skylights and other opening

windows and skylights accessible from roofs, decks, scaffolding (temporary or

permanent), balconies, fire escapes, canopies, down pipes or any other externally

protruding feature of the building such as roller shutter encasements or design

features must be fitted with key operated window locks or protected by solid steel

bars, grilles, cable gates, expanded metal or weld mesh             

PLEASE SELECT —Please choose an option—YesNo

19. Is the Interest of any Bank or Building Society to be noted?

PLEASE SELECT —Please choose an option—YesNo

20. Is this a new start up?

PLEASE SELECT —Please choose an option—YesNo

Please let us know where you found out about Micropub Insure.

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