GIB LETCOVER :: Insurance Solutions for Landlords and Property Owners

Vacant / Unoccupied Commercial Property Insurance Quote

Where did you hear about us?
If other please specify:
About you
First Name
Company Name (if applicable)
Date of Birth
Marital Status
Type of business
Telephone Number
Is policy to be in joint names?
Joint Policyholder (if required)
First Name
Date of Birth
Marital Status
Type of business
Correspondence Address
Property Name / Number
Risk Address Details
Property Name / Number
Property type
Is property fully unoccupied?

If property is not fully unoccupied, please advise which parts are occupied & by whom

(e.g. Unoccupied shop with occupied rented flat above etc.)

When did property become unoccupied?
How long will property be unoccupied for?
WHat are you intentions for the property
Buildings Sum Insured
Contents Sum Insured
Do you require Propert Owners Liability cover?
Is so, please advise level of cover
Construction Details
Is the property built solely of brick, stone or concrete and is either flat roofed or roofed with slate, tile or concrete?
If no, please give details fo construction
If property has some flat roof, please state percentage & construction
Year of Build?
Year of Purchase?
Is property a listed building?
If so what grade?
Number of storeys?
Upper storey floor construction?
Is there a Sprinkler system installed?
Risk Statement

You or any other joint owners have never:

- Suffered any loss or incurred any liability, whether insured or not, during the last 3 years as a result of the risks proposed (whether at this or any other premises) or had any claims made against you?
- Been convicted of, or in the course of being charged with, any offence (excluding driving offences) whether at these premises or elsewhere?
- Been declared bankrupt or been a director of any company that went into liquidation?
- Had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed?

The premises are:

- In a good state of repair and will be so maintained
- Heated solely by oil and/or electricity and/or mains gas and/or solid fuel
- Not close to cliff, quarry or other excavation
- Are not showing any sign of existing or previous damage by Subsidence, Heave or Landslip
- Free from any underpinning or any remedial action with regard to subsidence, heave or landslip
- Self contained with its own lockable entrance door from the street or landing
- In a position/area likely to be subject to flooding or where flooding has occurred
- NOT used for any hazardous processes or hazardous materials stored in or at the premises
- NOT having any structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned

Do you agree with the above statements?

If no, please state reasons why:

Claims Details
Please give FULL details of any claims made on either Buildings or Contents insurance within the last 5 Years
Date Cover to commence
Current renewal premium, if applicable
Current Insurer, if applicable
Additional Information

Please add any information you feel may affect the quotation.


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GIB LETCOVER ’ is a trading name of Gothic Insurance Brokers Ltd who are are authorised & regulated by the Financial Conduct Authority, Firm Number 300031
Registered Trading address : Gothic House, Station Road, Old Harlow, Essex, CM17 0AP