Contact Details:- Pub Details:- Please enter numerical values. £ £ £ £ £ £ £ 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 more than two losses or incidents giving rise to a loss whether insured or not during the last three 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? Protected by a level of physical security which conforms to our Minimum Physical Security Condition (Endorsement reference P002a) 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. —Please choose an option—Micropub AssociationCAMRA MagazineSocial MediaInternet Search EngineRecommendationReceived a letter
