Enquiry Form Non Agent - County Insurance Services

Type of property (please Check):*
- Terrace
- Semi-Detached
- Detached
- Bungalow
- Flat
- Barn Conversion
- Park Home
Occupancy (please Check):*
- Main Residence
- Professional Let
- Holiday Let
- Holiday Home
- Unoccupied
Working from home?*
Please Select
Please state the nature of the work carried out at the property:*
Has the property any history of subsidence, heave, landslip, flooding, or major fire?
If yes, please provide details:*
Building construction:*
Roof construction:*
Year of construction:*
Listed?*
Percentage thatch (%):*
Please enter a number from 0 to 100.
Type of Thatch:*
Type of heating at the property (Tick all that apply):*
- AGA Electric
- AGA Solid Fuel
- Gas Central Heating
- Multi Fuel
- Oil Fired Central Heating
- Open Fire
- Solid Fuel
- Solid Fuel Central Heating
- Storage Heaters
- Wood Burner
Are chimneys/ flues lined?*
Does the property have a 60 minute fire barrier?*
Does the property have smoke detectors?*
Is an up-to-date electrical installation certificate available?*
Is the property in a neighbourhood watch area?*

Is the property fitted with 5 lever mortice deadlocks and key operared window locks?*
If No, please give details:
Is there a NACOSS/ SSAIB alarm?*
If Yes, please state type:
Is the alarm covered by an annual maintenance agreement?*
Is there a safe?
If Yes, please give details:*

Main building (£):
Outbuildings (£):
Total building sum insured (£):
Is accidental damage cover required (Buildings section)?
General contents (£):
Outdoor Items (£):
Gold, SIlver & plate (£):
Redundant Jewellery, watches & other valuables never worn or taken outside the home (£):
Stamp & coin collections (£):
Fine art and antiques (£):
Total contents sum insured (£):
Is accidental damage cover required (Contents section)?
Unspecified All Risks (SAL £2,500):
Specified All Risks:
Pedal Cycles (up to £500 total):
Specified cycles over £500:

Please note that there is a compulsory policy excess of £100 on main residences and £250 on all others.
Voluntary excess in addition, Contents (please check):
- £100
- £250
- £500
- £1,000
Voluntary excess in addition, Buildings (please check):
- £100
- £250
- £500
- £1,000

Trustworthy, responsible and true