Get a Quote: Step 1 of 3 Please complete this online form and then click the 'Submit Proposal' button to proceed to the next step.   Please click here to exit from the 'Get a Quote' process.   * denotes mandatory information   General Information Name of Proposer: * Address and Post Code: * Telephone number: * Email address: *   Premises to be Insured Address and Postcode: * Number and type of units (terraced, semi etc): * Development Type i.e new build, refurbishment, conversion: * Contract Value: * Reinstatement Value of any pre-existing structure: Does this development include any element of non-residential use?: * Yes   No If so please give details including proportion of Contract Value and retained structure value:       Insurance Requirements Sum Insured: * (This figure must represent the Contract Value (including professional fees) if new build or the reinstatement value of the premises on completion if refurbishment/conversion)   Please tick covers required *   BLPSECURE  or BLPSECUREPLUS  10 year policy period or 12 year policy period   N.B. The standard excess of any claim is £1,000 per any one loss       Please give details of the body carrying out  the building control function Name address and contact details: PLEASE NOTE: IF AN APPROVED INSPECTOR IS BEING EMPLOYED TO CARRY OUT THE BUILDING CONTROL FUNCTION, THE CONTAMINATED LAND EXTENSION BELOW IS COMPULSORY.   ADDITIONAL COVERS: Contaminated Land Extension Yes   No   Do you require a waiver of subrogation rights against the professional team? Yes   No (a waiver of subrogation rights will disable the Insurers from making any recovery from any member of the professional team)   Is cover required for loss of rental income? Yes   No Please provide annual rental income: What indemnity period is required? (this represents the maximum period over which payments will be made and should normally represent the rebuild period of the premises)        Duration of Works Start on site date: * Anticipated Completion date: * (Please include even if work is completed) Is the Development phased? Yes   No If yes, please give details below:     Phase 1   Start of Construction: Expected date of practical completion:     Phase 2   Start of Construction: Expected date of practical completion:      Contract Details     Contract Parties       Name of Architect: Contact No: Name of Contractor: Contact No: Name of Engineer: Contact No:      Premises Information   If any individual structure exceeds GBP10m (Contract Value and any pre-existing structure) or is constructed from Green Oak then Ground/Site Investigation reports, method statements, Gantt (Program) charts and plans and elevations will be required before a formal quotation can be issued. You will also need to complete the Additional Information section below.       Retail Customer or Commercial Customer For insurance purposes you are either a Retail Customer or a Commercial Customer. You are a Retail Customer if you are an individual who is acting for purposes which are outside your trade, business or profession. Otherwise, you are a Commercial Customer.   Please tick one * Retail Customer or Commercial Customer       How did you hear about BLP? Marketing from BLP     Marketing from 3rd party who? Trade press which one? Search engine which one? Word of mouth who?       Additional Information   Site Preparation e.g. Any Vibro-Compaction or other remedial works, please detail below: Detail    Groundwater Conditions  High Groundwater Level/Water above basement level  Water below basement level/No other influence  Other    Foundations  Piling  Strip/Pad Foundations      Other    Structural Frame Type and Height  Steel or Cast In-situ        Concrete  Pre stressed or pre        cast concrete  Timber  Green Oak  Other      Height of Premises (in metres):  m Number of Floors: Number of Floors below ground and the % of Contract Value: Number of Floors above ground and the % of Contract Value:   Types of Cladding (if any)  Stone  Concrete  Walls  Curtain Walls  Brick  Prefabricated  Metal  Glass  Other    Roof Details  Flat <1%  Pitched >1% <5%  Pitched >5%   Tiles  Slates  Corrugated/Profiled Sheets  Other         Declaration I certify that all details in this proposal form are complete and true and to my knowledge no material information relating to the risk has been voluntarily withheld or omitted.   I understand that the submission of this proposal form does not bind us to effecting any policy of insurance but agree that if any quotation is accepted this proposal form and the statements made within shall form the basis of the contract between us and the insurers.   Name: * Position in Company: (Commercial customers only) Date: *       Conditions of Quote The information that you provide and the declarations that you make when obtaining a quote are the basis of the contract of insurance between you and Allianz Global Corporate & Specialty AG UK Branch. When providing information in order to obtain your insurance policy you must ensure all the information given is true and complete and that all material facts are disclosed.   A material fact is one that is likely to influence us in the assessment or acceptance of this risk. If you are in any doubt as to whether a fact is material, you must disclose it. You can telephone us on 020 7204 2424.   Failure to ensure the information you provide is true and complete and that all material facts have been disclosed may mean that your policy becomes invalid or does not operate in the event of claim.   I confirm that I have read and agree to the Conditions of Quote.   BLP is an underwriting agent of Allianz Global Corporate & Specialty AG (UK Branch) and all policies are underwritten by them.