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| Please ensure that all information you provide is correct and that you answer all questions accurately. |
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| These details will form the basis of the insurance policy and any incorrect information could invalidate all or part of the insurance contract. |
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| The proposer(s), or any partner, or any director, or any officer, have:- |
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| a) never been declared bankrupt or disqualified from being a company director |
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| b) no outstanding County Court Judgement(s) or Sheriff Court Decree(s) |
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| c) never been officers of a company that has been declared insolvent, or had a receiver or liquidator appointed, or entered into arrangements with creditors in accordance with the Insolvency Act 1986 |
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| d) never been convicted or have any prosecutions pending or been given an official police caution, in respect of any criminal offence other than motoring offences |
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| e) never had any insurance proposal declined, renewal refused, had any special or increased terms applied or had insurance cancelled mid-term by Underwriters |
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| f) never been prosecuted for failing to comply with any Health & Safety or Welfare or Environmental Protection legislation |
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| Your business:- |
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| a) has a minimum of 8 manual working persons including you, principals, partners, directors and officers |
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| b) has a written health and safety policy in force |
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