The Professional Indemnity for Architects and Construction Professionals, including Quantity Surveyors and Project Managers - Quotation Form

Premiums from £491.00

To obtain your quotation please submit the on-line form below * = required field

1. Name and Address of Business

Contact Name: * Business Name: Address 1: Address 2: Address 3: Town: County: Postcode: Telephone: * Fax: E-mail: * Date Established:

2. Please provide details of each partner as follows:

Name Age Qualification Years experience

3. Fee Income - Please give an approximate percentage split according to type of work:

Type of work % Architecture Interior Design Structural Engineering HVAC and Electrical Consultancy Mechanical Engineering Quantity Surveying Structural Surveys or Valuations Civil Engineering Project Management Other Work - please specify below

4. Please give the approximate percentages applicable to the following expressed as a percentage of the total gross fees for the last complete financial year:

Type of work % Public Sector Schools or Universities Private Sector Schools or Universities Public Sector Hospitals Private Sector Hospitals Other Healthcare Public Sector Housing (including Housing Associations) Private Sector Housing Schemes Private Sector Individual Houses Churches/Cathedrals Industrial Commercial Schemes Other Work - if over 10% please specify below

5. Please state the 3 largest contracts where construction has commenced in the last 5 years:

Start Date Completion date Contract Description Contract Value

6. Please state the 3 largest contracts where construction is expected to start shortly:

Expected Start Date Expected Completion date Contract Description Contract Value

7. Please give amount of income for the last 3 financial years plus estimate for the coming financial year.

Year Income

8. Do you have any work involving the following:

Landfill/toxic waste/asbestos Tunnels/mines Offshore work Petro-chemicals plants High rise (over 6 storeys) Docks Coastal Defences Demolition

9. Current Insurance Information

Name of current Insurer Expiry Date of current policy

10. Have any claims ever been made against you?

Yes No If so please give details:

11. Are you aware of any circumstances that may give rise to a claim?

Yes No If so please give details:

12. Limit of Indemnity Required, please select preference/s

£100,000 £250,000 £500,000 £1 Million £2 Million £5 Million

If you experience problems with the on-line quotation form please contact us

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