Risk Details

Please provide details of the buyer and required levels of cover.
If you do not know the UK Company Registration Number you can find it here Companies House (opens in a new window)

Buyer name

Buyer country

Buyer reg number

Credit limit

Is the buyer a new customer to you?

Yes No

Nature of business

Special requirements

Contractual payment terms

From

Nature of risk

Single Contract

Continual Trade

Additional Information

Declaration

I declare that the information given in this Questionnaire is correct to the best of my knowledge and belief and I/we are not aware of any circumstances other than those disclosed in this Questionnaire which might influence insurers’ acceptance of the risk.

Single Buyer Quote

Company Details

Risk Details

Additional Information

Declaration