Our Privacy Statement, Terms and Conditions and other important documents are those on which we intend to rely and for your own benefit and protection we urge you to read these carefully before proceeding. If you do not understand any point please ask for further information.

I agree to receiving marketing information from Bridge Insurance Brokers Ltd or from selected business partners Yes No

Name:

Salutation:

Trading name:

1st line of address:

Postcode:

Are you a member of the British Florist Association?

Please select Yes No Yes through Flowers Direct Membership Yes through Flowergram Membership Yes through Flowers By Florists Membership Yes through Society I'm thinking of joining

Contact Telephone Number

Email Address

Number of years trading

Please select Under 1 Year 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years Over 10 Years

Are the Premises of standard construction?
i.e. Brick/Stone walls with Tile/Slate pitched roof. Please note: If you have a flat roof please provide % of the total roof and construction type(s).

Please Select Yes No - Building is Non Standard - Describe in further info box No - Roof is Flat - Describe in further info box No - Other - Describe in further info box

Is the building solely occupied by you as a florist?
(If you use market stalls, please contact our office)

Please select Yes No, Please describe in further info box

Is the property free from Flood, Ground Heave, Landslip and Subsidence, having never been underpinned?

Please select Yes No

Do you require Terrorism Cover?

Please select Yes No

Are the premises protected by an operational intruder alarm?

Please select Yes No

If yes, please provide details:

Are the premises occupied overnight?

Please select Yes No

Are the premises covered by a 24 hour town centre CCTV camera system?

Please select Yes No

Do the premises have shutters / grilles on the shop front?

Please select Yes No

Are the premises fitted with bars on all accessible side and rear windows?

Please select Yes No

Do you comply with points A-C of the minimum standards of security as shown above here?

Please select Yes No

Do you require buildings cover?

Please select Yes No

If yes, please enter sum insured required:

£

Trade fixtures, fittings and all other contents sum insured:

£ Please enter a figure here.

Stock Sum Insured:

£ Please enter a figure here.

Any other property?

£

Do you wish to increase the property in transit cover higher than the standard £2,500?

Please select Yes No

If yes, please enter the required sum insured:

£

Employers Liability Cover Limit

£ 10,000,000 (standard)

Public/Products Liability Cover Limit required:

£2,500,000 £5,000,000

Have there been any incidents in the last three years which have or could result in a claim?

Please select Yes No

If yes, please provide details:

Date:

(dd/mm/yyyy)

Value:

£

Describe circumstances:

Date:

(dd/mm/yyyy)

Value:

£

Describe circumstances:

Who is your current insurer?

When is cover required?

(dd/mm/yyyy)

What are you currently paying?

£

Any further information:

IMPORTANT: In order for us to process your quotation please confirm that you understand the insurer minimum standards of security.

We also make certain assumptions to provide you with a fast quotation. By ticking the box you confirm that you have read and agree with the statements click here to view

Tick here Please contact us on 0845 313 9871 if you cannot proceed any further.

NOTE: If information provided is incorrect or incomplete Insurers may not pay your claim. Details you provide may be checked by Insurers against data held elsewhere.