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1. PROPOSER DETAILS    
(a) NAME OF PROPOSER and Subsidiary and/or affiliated companies
(b) STATE CONTACT NAME and ADDRESS of the premises to which the policy is to apply
(PLEASE COMPLETE A SEPARATE FORM FOR EACH ADDRESS)
POST OR AREA CODE:   
COUNTRY: 
TEL:  FAX:           EMAIL:
MOBILE:     WEBSITE:
(c) WHEN DID YOU OR YOUR COMPANY COMMENCE TRADING?

2. STOCK VALUES    
(a) WHAT IS THE AVERAGE TOTAL VALUE OF YOUR OWN STOCK, MONEY AND
GOODS IN TRUST USED IN THE CONDUCT OF YOUR BUSINESS ?
(b) WHAT IS THE ESTIMATED MAXIMUM VALUE OF STOCK, MONEY AND GOODS IN
TRUST AT ANY TIME ?
(c) SEASONAL INCREASE    FROM   TO  SUM INSURED INCREASED
BY AN ADDITIONAL
ADDITIONAL INFORMATION
(d) VALUES DISPLAYED IN THE WINDOWS
(i) WHEN THE PREMISES ARE OPEN
(ii) WHEN THE PREMISES ARE CLOSED
(e) VALUES LEFT OUT OF SAFE WHEN THE PREMISES ARE UNATTENDED
STATE THE LIMIT REQUIRED IN RESPECT OF JEWELLERY, WATCHES OR PRECIOUS METAL LEFT OUT OF SAFE WHEN CLOSED OR UNATTENDED
(f) MAXIMUM VALUE OF A SINGLE ARTICLE OF JEWELLERY OR WATCH
STATE THE MAXIMUM VALUE OF ANY SINGLE ARTICLE LEFT OUT OF SAFE WHEN THE PREMISES ARE CLOSED OR UNATTENDED

3. SENDINGS    
(a) WHAT IS THE ESTIMATED ANNUAL VALUE OF GOODS DESPATCHED BY POST, CARRIER OR COURIER?
(b) WHAT IS THE MAXIMUM VALUE OF ANY ONE PARCEL DESPATCHED BY POST, CARRIER OR COURIER?

4. OUTSIDE LIMIT      
WHAT LIMIT, INCLUDING IN RESPECT OF SENDINGS, IS REQUIRED FOR ANY ONE LOSS FOR PROPERTY (STOCK, MONEY OR GOODS IN TRUST) ELSEWHERE THAN AT YOUR PREMISES ?

5. ADDITIONAL INFORMATION      
(a) HOW MANY EMPLOYEES HAVE YOU ?
(b) STATE YOUR APPROXIMATE ANNUAL SALES TURNOVER.
(c) ARE YOU CURRENTLY INSURED ?
(d) IF YES WITH WHOM ARE YOU INSURED ?
(e) ON WHAT DATE DOES YOUR POLICY EXPIRE ?
(f) ARE YOU CURRENTLY INSURED OR HAVE YOU EVER BEEN INSURED THROUGH GJIS IN THE PAST ?

6. LOSSES      
(a) HAVE YOU EVER SUSTAINED A LOSS OR LOSSES UNDER THE TYPE OF POLICY NOW PROPOSED WHETHER INSURED OR NOT ?
(b) IF YES GIVE STATEMENT COVERING THE PAST FIVE YEARS WITH PARTICULARS, INCLUDING THE AMOUNT OF EACH LOSS AND, IF INSURED WHETHER PAID IN FULL OR OTHERWISE.
PLEASE INDICATE THE LIKELY COST FOR INSURANCE BASED UPON THESE PARTICULARS. I/WE UNDERSTAND IT IS A GUIDE ONLY AND THAT IT DOES NOT BIND ME TO COMPLETE ANY INSURANCE AND THAT ANY INSURANCE WE EFFECT IS SUBJECT TO THE COMPLETION OF A FULL PROPOSAL FORM SHOULD I/WE WISH TO PROCEED.
  I HAVE READ AND ACCEPT PRIVACY STATEMENT AND AGREE WITH TERMS AND CONDITIONS FOR USING THIS WEBSITE.
FOR AND ON BEHALF OF:   DATE:
   CLICK HERE TO SUBMIT YOUR DETAILS   
EMAIL: insurance@gjis.co.uk WEB: www.gjis.co.uk
 

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