Spa Insurance Services

Please complete all the details required below

Personal Details
Your Name (First Name/Last Name )
Your Address
E-mail address:
Contact telephone number:
Renewal date:


Property Details
Address of property to be insured:
Postcode:
Date Built?
Property Type:
Type of Residential Tenant(s):
Type of Commercial Tenant(s):
Minimum length of tenancy agreement?
Occupancy Status:


Claims History
Please details below ALL and ANY losses you have suffered or claims you have made in the last five years:


Sums Insured
Buildings Sums Insured:
Property Owners Liability:
Optional Extras:
Loss of Rent (12 mths):
Landlords Contents Sums Insured:
Employers' Liability:


Other Property Details:
Is the property:
1. A listed building?
2. Self-contained?
3. In a good state of repair?
4. Constructed of brick, stone or concrete and roofed with slates, tiles, concrete or rigid metal?
5. In an area free from subsidence, ground heave, slip etc.
6. In an area free from flooding


Additional Comments
Please add any additional comments here