Your Name
 

Your Email
 

NIE / NIF
 

Business Name
 

CIF Number
 

Postal Code
 

Size of premises m2
 

Year of Construction
 

Type Of Premises
 

Buildings / Structure Cover Required
 Yes No

Structure Insurance Amount If Required
 

3rd Party Liability
—100,000 €200,000 €300,000 €

Employees Liability
 Yes No

Civil Works Or Products
 Yes No

Theft Cover
 Yes No

Fixture & Fittings Value €’s
 

Stock Value €’s
 

Equipment/Machinery Value €’s
 

Security. Check If Installed
 Fire extinguishers on contract Smoke detectors All windows, doors and openings protected 24/7 Security Sprinklers Alarm connected to security company Shutter or security grill

Telephone No.
 

Where Did You Hear About Us?