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Survey Request - MGA
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Survey Request - MGA
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Applicants Information
Your Name
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Your Company Details
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Survey Information
Company to be Surveyed (the Insured)
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Trade / Occupation
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Policy Number
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Address
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Postcode
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Survey Options
Type of Survey
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Full Format Property Combined
Full Format Liability Combined
Commercial Survey report
Property Owners report
Contractors Site report
Other / Bespoke
Broker Bursary review report
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Other / Bespoke
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Reason for Survey
New Business
Resurvey
Post Loss
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Priority
Standard
Urgent
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Contact Details
Broker Name
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Broker Contact Name
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Broker Telephone Number
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Survey Contact Name
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Sums Insured
Buildings
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Stock
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Gross Profit / Revenue / AICOW
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Machinery / Fixtures / Contents
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Other
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Indemnity Period
12 months
24 months
Other
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Financial Details
Manual Wages
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Other Wages
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Clerical Wages
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Turnover
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Additional Information
Attachment 1
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Attachment 2
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Attachment 3
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Attachment 4
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Attachment 5
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Attachment 6
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Special Instructions / Additional Information
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