Please answer the following questions and press "Send". All fields are mandatory

1. Broker Details

Broker Name
Broker Contact
Broker Phone Number
Broker Email Address

2. Park Details

Name of Proposer(s)
Full Address of Park
Park Web Site
Renewal Date
Type of Park (insert number of units / licenced pitches)
Static Holiday Caravans
Mobile Homes
Holiday Lodges/Chalets
Camping & Touring
Open period for park:    From:
To:
Will the park be left unoccupied during any closed period?
Has the site or surrounding area any history of flooding?
Is the site in an exposed area susceptible to storm damage?
Does the site have access control?

3. Facilities

Do you have a Clubhouse?    Residents only
Open to Public
Describe Clubhouse facilities
Do You Have a Swimming Pool?    Indoor
Outdoor
Please state Dimensions?
Is it approved by Local Authority?
Describe safeguards in place to protect users
Any water Flumes Diving boards etc.
Please describe any other activities/facilities in place e.g.) play area, toilets and showers, laundry, boating lake etc.
Please state types of shop/ catering facilities etc provided

4. Risk Details

Public/Products Liability    £1,000,000
£2,000,000
£5,000,000
Not Required
Employers Liability    Yes
No
Please provide total annual wageroll:    Clerical
All others
Please provide total annual turnover:    shop/restaurant
All other activities
Material Damage    Fire and Perils
AD
Subsidence
Not Required
Please Provide sums insured for:    Buildings
Constructed of
Stock
Wines & Spirits & tobacco
Other Contents
Caravans: Sales Stock
For Hire
Are all Caravans anchored on each corner ?
Loss of Revenue - Indemnity Period    12 Months
18 Months
24 Months
Revenue
Loss of Licence - Sum Insured
Money - Please state Maximum Value    In Transit
In Premises
In Safe
Deterioration of Stock - Sum Insured

5. Claims Experience

Please provide details of any claims or incidents likely to give rise to a claim in the past 5 years whether a claim has been made or not.

6. Material Facts

Please provide any additional information you feel will be relevant to this enquiry. (If in doubt as to whether or not it is material please disclose it anyway).