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General Insurance Services
Liability Insurance

Cover for liability incurred in the course of exercising a profession.

If you would like to receive a quote for Liability Insurance, please download the form. Alternatively, please fill in all the fields on the online form and click send.

Personal Details
Title:
First Name:
Surname:
Correspondence Address:
Post Code:
Telephone No:
Email Address:
Risk Address:
(If different from the
Correspondence Address)
Post Code:
Full description of
business activities:
Trading Name:
Years Trading:

Financial Data
  No. of People         Payroll Renumeration (£)
Clerical/Managerial:       
Manual Employees:       
Manual Principals:       
Work Away:       
   
Annual Turnover (£):
   
Does any work away from premises
involvce application of heat?:
If yes, please provide details
   
Public Liability:
Employers Liability:
Current Insurer:
Renewal Date:    dd/mm/yy
Have you made any claims
over the past 5 years?:
(if so please give details):
   
Agent Ref :    (if applicable)
   
     
AHS Insurance Ltd, Alexandra House, Alexandra Road, Swansea, SA1 5ED    Telephone: 01792 465141    Fax: 01792 643237
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