Yellow Bolts - Renovation / Extension Insurance Proposal Form
PLEASE ANSWER ALL QUESTIONS HONESTLY, ACCURATELY AND TO THE BEST OF YOUR KNOWLEDGE. The answers you provide will form the basis of your insurance quotation. If you are unsure about what is relevant, please let us know as it may influence the insurer’s decision to accept the risk or could impact the terms of cover.

Please provide as much information as possible and in sufficient detail to enable us to obtain the most appropriate terms. Failure to provide full and accurate information may result in a claim being rejected or only partly paid, your policy being cancelled, additional terms being applied, or an additional premium being charged.
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Name of proposer(s) *
Email Address
Phone Number
Is the insured UK domiciled? *
Policyholder 1 date of birth *
Correspondence address *
2. Existing Structure
Risk address *
Type of building *
Basis of cover requirement *
Rebuild cost of property prior to works starting *
Please provide the rebuild / reinstatement cost, not the market value.
Number of storeys including basement level *
Is this a commercial development? *
Construction of existing walls *
Construction of existing roof *
Construction of floors *
Construction of staircases
Clear selection
Approximate year of build of property
Listing grade *
Location details *
Nearest occupied property *
Structural condition *
Comments regarding structural condition
Do you require cover for either advanced loss of rent or future interest payments? *
Has the property ever suffered from subsidence, heave, landslip, flood, storm or malicious damage in the past? *
If yes, please provide details
Previous use of the property *
Eventual intended use *
Is lender interest to be noted? *
If yes, please provide lender details
Is terrorism cover required? *
3. Contract Works
Total project cost including main contract, subsidiary contracts, direct purchases, professional fees and VAT *
This should represent the total cash cost of the project to the renovator.
Summary of works to be carried out *
Include any non-standard construction materials / methods, excavations, demolition, roofing changes, extensions, loft works, etc.
Are any of the adjoining / surrounding properties undergoing significant structural works concurrently with this project? *
Does this project require planning permission? *
Has planning permission been granted? *
Will the works involve piling and/or underpinning? *
If yes, please provide full details of the methodology
Will the works involve excavation to a depth exceeding 3 metres? *
If yes, please provide full details
Has an architect been appointed? *
Has a structural engineer been appointed? *
If yes, please provide details
Has a contractor been appointed? *
Trading title of contractor
Type of contract (Example, JCT Minor, JCT Home etc)
Contractor Companies House number
On-site contractor contact (including telephone number and email)
Are you required by contract to note your contractor(s) as a joint insured? *
Estimated duration of project *
When does / did the project start? *
Do you require more than 60 days of building cover prior to the start of the project? *
4. Hired In & Own Plant
Is cover required for hired in or owned plant? *
Own plant – total sum insured
Own plant – single item limit
5. Liability
Are you appointing a main contractor who will be in overall control of the site? *
Public / products liability limit of indemnity required *
Do you require non-negligent party wall liability insurance? *
6. Risk Management - Security
Is there site hoarding? *
Is there an alarm system which will be operable during the works? *
Is there CCTV or a security guard? *
Will scaffolding be alarmed? *
Will anyone be living on site during the works? *
Any other security measures? Please provide details
7. Risk Management - Fire
Is there a fire alarm system which will be operable during the works? *
Has a documented fire risk assessment been undertaken? *
Will the joint fire code be complied with (required where the contract value exceeds £2.5m)? *
From the point that works start, will there be fire extinguishers on site? *
Will there be a no smoking rule on site? *
Will waste be removed from the site on a daily basis, or stored in a fire-proof skip at least 5 metres from the structure? *
Will a hot works permit system be in operation? *
Has the fire brigade been advised that this project is taking place? *
Is there a hydrant, or sufficient water from other sources to tackle a major blaze? *
8. Risk Management - Site Management
Is there a main contractor in overall control of the site? *
Will sub-contractors be under the direct control of the main contractor? *
Will any sub-contractors be paid directly by you (not by the main contractor)? *
Will formal site induction procedures be in place? *
9. General Questions
As an individual, or as a director of a company, have you or any joint proposer had an insurance proposal declined, renewal refused, insurance cancelled or special terms applied? *
If yes, please provide details
Have you or any joint proposer had a conviction, been charged but not yet tried, or been given an official police caution in respect of any criminal offence other than a motoring offence? *
If yes, please provide details
Have you or any joint proposer been a director or partner of a company which has gone into insolvency, liquidation, receivership or administration, or been disqualified from being a company director? *
If yes, please provide details
Have there been any incidents in the last 3 years which have, or could have, resulted in a claim at any address? *
If yes, please provide details
Any additional information that may be relevant
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