Address
Please provide the following details of all Partners/Directors/Principals:
Is coverage required in respect of past work for any Partner/Principal who has left, retired or died? YesNo
If ‘YES’ please give the following:
Please state the following:
Please state the 5 largest contracts where construction has commenced during the past 6 years
Please give details of Contracts where construction is expected to commence in the next 12 months
State whether you undertake Supervision of Contract works being executed? YesNo
If Yes, periodicity of inspection with details:
Do you engage persons outside your organization? YesNo
If yes, specify the details of purpose and nature of control exercised by you over them Loss Record for 5 years
Have you during the past 12 months dismissed or do you contemplate dismissal of any member of staff on account of any omission, neglect, error or such like? YesNo
If Yes, please give full details
Are you aware of any neglect, omission or error or existence of any circumstances likely to give rise to a claim? YesNo
Please give gross fees received during the past five years
Has any company declined your proposal? YesNo
Has any company required an increased premium? YesNo
Has any company refused to renew your policy? YesNo
Has any company cancelled such a policy? YesNo
