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restaurants online application
Proposer details
Status of Proposer
*
Please select
Limited Company
Partnership
Limited Partnership
Sole Trader
Proposer Name
*
Trading Name
Contact details
Salutation
*
Please select
Mr
Mrs
Miss
Ms
Dr
Contact Name
*
Email
*
Address of Premises to be Insured
*
Town/City
*
Post code
*
eg. N21 2EP
Correspondence Address same as premises address ?
*
Yes
No
Address
*
Town/City
*
Post code
*
eg. N21 2EP
Telephone number
*
Date established
*
/
Type of business
*
Restaurant Licensed
Restaurant Unlicensed
Other
Please give full details
Are you the sole occupant(s) of the premises in which your business is situated?
*
Yes
No
Please give full details
Are your premises entirely self-contained with their own means of access?
*
Yes
No
Please give full details
Your quote ref:
IPS001/0000220280238/2018/000
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IPS Insure is a trading style of IPS Terroni Insurance Services Ltd