Consultant Engineers Professional Indemnity Insurance

Professional Indemnity Insurance for Consulting Engineers
Title Of The Proposer
Proposer's First Name
Proposer's Surname
Company Name
Address First Line
Address
Town
County
Postcode
Telephone Number
Fax Number
Email Address
Date Cover Required from
What Type of Company
Trading From (Date)
Retroactive Date		See glossary
Limit of Indemnity		See glossary
Excess		see glossary
Is the company domiciled outside the UK?			details if yes
Has there been any change in Business Activities in the last 12 months?			details if yes
Do you anticipate and changes in the Business Activities in the next 12 months?			details if yes
Do you generally obtain written instructions from clients in respect of work you are to undertake for them?			details if yes
Do all Directors/Partners have professional Qualifications or at least 5 years experience?
Number of Directors/Partners
Number of Professional Qualified Staff
Number of all other staff
Do you use Independent Consultants as sub-contractors?			details if yes
Do you obtain references when engaging new staff
Current Year Gross Income	£	Last Years Gross Income	£
Largest Fee	£	Estimated Gross Income	£
Financial Year End		DD/MM/YY
Category of Business		% of Fees
Architectural
Civil/structural
Mechanical/machinery Equipment
Landscape Architecture
Quantity Surveying
Construction/project Co-ordinator
Process/chemical/nuclear
Project Management
Soil/environmental
Heating/ventilation/electrical
Foundation/underpinning
Other
Type of Work		% Type
Housing/office - Low Rise
Housing/office - High Rise
Retail/warehousing
Manufacturing/industrial
Educational/recreational
Water/waste Treatment
Road/highways
Bridges/airports/harbours
Amusement/fairground Rides
Landfill/petrochemical/atomic
Hotel/multi-storey Car Parks
Any Others
Do you undertake work for clients domiciled outside the UK?			details if yes
Do cheques need to be signed by more than one person?			details if yes
Have you had and claims or are you aware of any incidents that may give rise to a claim?			details if yes
Have you ever had insurance refused or cancelled or any special terms imposed by underwriters			details if yes

Consultant Engineers Professional Indemnity Insurance

Professional Indemnity Insurance for Consulting Engineers