Buildings & Contents Insurance

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Clearchoice Home Insurance

arranged by

Strathclyde Police Federation

Building & Contents Insurance Quotation Form
IMPORTANT: A specimen policy is available on request.
For your protect telephone calls may be recorded, and may be monitored.
The purpose of this form is to enable us to contact you. It does not form any part of your insurance contract.

To obtain a guaranteed quotation we will need to ask you some standard questions which we normally ask all our customers.
PROPOSER
Title:	First Name:	Surname:


Please state the serving police officer's Force:
Please enter the serving police officer's register / payroll number:

Date Of Birth (dd/mm/yyyy):


Home Address:
		Telephone (Home):
		Telephone( Work):
		Telephone (Mobile):




Post Code:

e-mail address:

What time of day would you like us to contact you:
Morning (9.00am - 12.00 noon) or Afternoon (1.00pm - 5.00pm)

What is your current renewal date (dd/mm/yyyy):

Please state your Current Insurer:

ELIGIBILITY
When we provide you with a illustration quote we will assume that the following is true;
Your home is occupied solely by you and your family and is your main residence Your home is not left unoccupied for a total of more than 60 days a year Your home is in good repair and self contained Your home shows no sign of or has not had any damage caused by subsidence, landslip or heave Your home is on a site that has not been flooded in last 10 years If you use your home for business purposes, it is only clerical work You and your family have not sustained any loss, damage or liability during last 5 years You and your family have no unspent convictions, cautions or prosecutions pending (other than parking or speeding offences) You and your family have not had an insurer decline, cancel or declare void any household insurance or have had special terms applied.
In some circumstances you may still qualify for home insurance, please complete your details and we will telephone you to discuss your requirements.
GENERAL QUESTIONS
Construction / Type
1. Is your home built of brick, stone, concrete and roofed with slate or concrete? Yes or No:

2. Is your home:

3. Number of Bedrooms:

4. What year was your home built:

Buildings
What is the rebuilding costs of your home?

Contents
What is the total replacement cost of your contents?

Personal Belongings
Do you require cover for your personal belongings away from your home? Yes No

Click Submit to e-mail the information to us, or Reset to clear the form.