If you would like us to provide a quotation for your existing holiday home or are in the process of buying, please telephone us on 01934 424 040 or complete the form below and click on the submit button.         Name: Date of Birth:     Address in UK   Address:     Town/City: County: Postcode:     Daytime Telephone No: Home Telephone No: Email:     Address of Property to be Insured: Address:     Town/City: Postcode: Country: Please Select United Kingdom Andorra Cyprus France Greece Ireland Italy Malta Monaco Portugal Spain If a UK holiday home, what was the approximate year that it was built?      Property Use: Please Select Holiday Home (own use & friends/family) Holiday Home/Let (own use & let commercially) Is the property to be Insured of standard construction: Please Select Yes (Built of brick, stone, or concrete & roofed with slate, tiles or concrete) No (please give details in comments below) Is the property in a good state of repair:  Please Select Yes No (please give details in comments below) Value of Buildings (Rebuild Cost): Value of Contents:   Does the property have a private Swimming pool:     Yes No         Claims history on any properties during the    last six years:  Please Select 0 1 (please give details in comments below) 2 (please give details in comments below) 3 (please give details in comments below) 4 (please give details in comments below) 5 (please give details in comments below) 6 (please give details in comments below) How frequently will the property be checked when not occupied:  Please Select Weekly Twice a Month Monthly None of the above (Please give details in comments below) Renewal Date or Date Cover Required:     AGENTS REF (if Applicable)       Comments or Enquiries:

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