Fillable Property Owners and Contract Works Proposal (JCT Insurance)

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Property Owners and Contract Works Proposal (JCT Insurance)

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The Property Owners and Contract Works Proposal (JCT Insurance) form is 4 pages long and contains:

  • 1 signature
  • 36 check-boxes
  • 45 other fields

Country of origin: UK
File type: PDF

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Property Owners and Contract Works Proposal
Proposal Form for JCT Contracts
Please return completed form to:-
Expert Insurance Group Horsted Square Bellbrook Business Park Uckfield Sussex TN22 1QG or Fax 01825 761479
w: www.jctinsurance.com t: 01825 745 410 e: enquiries@jctinsurance.com
Expert Insurance Group is a trading style of Affinity Select Insurance Services Limited
Authorised & regulated by the Financial Services Authority Registered in England No 3565404
Please complete in CAPITAL LETTERS using black ink and tick boxes as appropriate. Please complete all questions where applicable
and provide full details where applicable, particularly for questions with GREY boxes.
1
Employer/Property Owner Details
Name
Occupation
Date of Birth
Correspondence Address
Telephone Number
Email Address
2
Generic Proposer Risk Information and Declarations – have any of the above proposers for this insurance:
Made an insurance claim on property insurance (whether paid or not) in the last 5 years?
No
Ever been convicted of any criminal offence, other than a motoring offence?
No
Ever been declared bankrupt or subject to bankruptcy proceedings?
No
Ever had property insurance declined, cancelled or any special terms imposed for any reason?
No
3
Details of Professionals involved in the Work. If these are not Limited (LTD) or Partnership Entities (LLP), please also advise a
contact name and a contact telephone number
Contractor
Is the Employer/Property Owner in any way related or associated with the Contractor?
No
Architect
Structural Engineer
Our forms can be completed within Adobe, without the need to print them out
Property Owners and Contract Works Proposal
Proposal Form for JCT Contracts
Please return completed form to:-
Expert Insurance Group Horsted Square Bellbrook Business Park Uckfield Sussex TN22 1QG or Fax 01825 761479
w: www.jctinsurance.com t: 01825 745 410 e: enquiries@jctinsurance.com
Expert Insurance Group is a trading style of Affinity Select Insurance Services Limited
Authorised & regulated by the Financial Services Authority Registered in England No 3565404
4
Details of the Property to be Insured
Address of Property undergoing Works
Type of Property e.g. detached bungalow, terraced house, semi-detached house etc.
Rebuild/Reinstatement cost of the Property
£
Are there any Contents to be insured? Please note:
This cover is for basic contents such as furniture, tables and
chairs. No cover is provided for high risk items such as
jewellery, money, bicycles and electronics.
£
Construction of the walls and roof e.g. Brick and Tile
What percentage of the roof is flat?
Approximate year of build
Previous / Current Insurer
Is there any lender to be noted on the insurance?
Is the Property being used for business use?
No
Is the Property grade listed?
No
Is the Property adjoining a Thatched Property?
No
Is the Property NOT in a good state of repair?
No
Has the Property ever suffered from, or is it built in an area with a history of subsidence?
No
Has the Property ever suffered from, or is it built in an area with a history of flooding?
No
Is the Property WITHIN 200 metres of any watercourse or body of water?
No
5
Details of the Works to be Insured
What are the estimated dates for:
Start
Completion
Please provide an overview of the Works being carried out at the premises
Will there be any use of heat other than for general plumbing?
No
Property Owners and Contract Works Proposal
Proposal Form for JCT Contracts
Please return completed form to:-
Expert Insurance Group Horsted Square Bellbrook Business Park Uckfield Sussex TN22 1QG or Fax 01825 761479
w: www.jctinsurance.com t: 01825 745 410 e: enquiries@jctinsurance.com
Expert Insurance Group is a trading style of Affinity Select Insurance Services Limited
Authorised & regulated by the Financial Services Authority Registered in England No 3565404
Will the Works involve Excavation exceeding five metres, Works in or adjacent to a body of water
(including swimming pools), or any Piling?
No
Will there be any Structural Work? If “Yes” please provide details and drawings relating to this
No
If the Works have already started, please advise how much has been spent to date and what Works have already taken place
Is there a JCT or other type of building contract in place? If so, please advise the contract terms and conditions/clause details to be
used e.g. JCT Minor Works 2016, Clause 5.4B
Is there any element of a New Build to be undertaken e.g. separate house or garage?
No
Will any materials be Salvaged or be Direct Purchases? If “Yes” please advise:
No
Salvage Value
£
Description of Materials
Storage Details
Direct Purchase Value
£
Description of Materials
Storage Details
What is the total value of the Works? This should include any
non-reclaimable VAT and Professional Fees, but exclude any
Salvage & Direct Purchases listed above
£
When the Works are complete, what will happen to the Property?
Please describe the location of the Property, e.g. urban, sub-urban, rural etc.
Where is the nearest occupied Property in relation to the Property to be insured?
If the Property will not be occupied during the Works, who will be responsible for securing the site at the end of the day?
Who will be inspecting the site and how often will they be doing this? Ideally, this should be someone other than the Contractor
Property Owners and Contract Works Proposal
Proposal Form for JCT Contracts
Please return completed form to:-
Expert Insurance Group Horsted Square Bellbrook Business Park Uckfield Sussex TN22 1QG or Fax 01825 761479
w: www.jctinsurance.com t: 01825 745 410 e: enquiries@jctinsurance.com
Expert Insurance Group is a trading style of Affinity Select Insurance Services Limited
Authorised & regulated by the Financial Services Authority Registered in England No 3565404
Please Note: A text based signature is not accepted by insurers
What security is to be in place during the Works? e.g. alarm scaffolding, door and window locks, fencing/hoarding etc.
If planning permission was necessary, please advise the name of the council which has granted the permission and the planning
application number
Do you require a quotation Non-Negligence Insurance?
A separate form will need completing and returning to us in order to obtain a full quotation.
No
IMPORTANT
Please read the following carefully before you sign and date the Declaration.
If you have answered “Yes” to any of the questions on this enquiry form with a GREY BOX, please supply any Additional Information
unable to be included in the space provided below.
The questions on this proposal form and any other details we specifically request relate to facts which we consider material to
underwriting this insurance. However, because no list of questions can be exhaustive please consider whether there is any other
material information which is known to you which could influence our assessment and acceptance of the risk. Failure to disclose all
material facts whether or not the subject of a specific question may invalidate your insurance.
We recommend that you should keep a record, including copies of letters and this Proposal Form, of all information supplied to us for
the purpose of entering into this insurance.
DECLARATION
Before signing the Declaration please check your answers carefully, particularly if this Proposal Form is not completed in your own hand.
I/We declare that to the best of my/our knowledge and belief the answers given are true and complete.
I/We agree that if any answers have been completed by any other person, such person shall for that purpose be regarded as my/our
agent and acting on my/our behalf.
I/We agree that the information provided on this Proposal Form and any information supplied by me/us shall be incorporated in and
form part of the insurance contract.
Signature of Proposer(s)
Date of signing
Title of Signatory:
Additional Information:
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Property Owners and Contract Works Proposal (JCT Insurance)

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Completed 10 June 2021

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