Quotation Form

Name of owner / contact person
NIE / CIF / DNI Nº.
Tel./Mob. Number for Contact person
Email
Address
Post Code
Name of Business
NIE / CIF / DNI Nº.
Tel./Mob. Number(s)
Email
Address
Post Code
Year Built
Year Refurbished
Size in sq meters (all floors)
Size in sq meters of patio/terrace areas
Number of floors
Type of Ownership

Type of Ownership Owned Rented
Type of Business
Annual turnover (approx)
If a bar - Capacity
Number of Employees
Value of Equipment & Machinery

Value of Equipment & Machinery 5,000 10,000 15,000 Other Other
Value of Stock

Value of Stock 1,000 2,500 5,000 Other Other
Type of Contruction

Type of Contruction Normal Bricks & Mortor With Wood ( more than 15% )
Security Measures

Security Measures Front Door - Security Front Door - Solid wood or Glass Multi-lever locks Bars on ALL windows Shutters on ALL windows/access points Alarm - connected to central system Alarm - NOT connected to central system Anti-robbery Glass (6mm + 6mm) Safe (concreted in with 2 keys, 2 combination locks or 1 of each) Safe - weighs more than 100 Kilos
Other Liberty policy numbers

FOR EXTRA DISCOUNT : Specify other Liberty policy numbers
Public Liability
(Automatically included on all policies)

Public Liability
(Automatically included on all policies) 300,000 450,000 600,000
IBAN CODE : 24 Characters.
e.g. ES07 1234-1234-1234-1234-1234

Policy MUST be paid by Direct Debit to qualify for CashBack and other offers.
Any Comments, Questions or Suggestions :
Required Start Date
(can be date of application) Required Start Date
(can be date of application) / DD / MM YYYY
Data Protection/Ley de Protección de Datos

Data Protection/Ley de Protección de Datos I agree to the sending and retention of this personal data in compliance with The Data Protection Act. / Estoy de acuerdo con el envío y la retención de estos datos personales de acuerdo con la Ley de Protección de Datos.
Type the letters you see in the image below.