ISACS

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* 1. Business Name:

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* 2. Contact Name:

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* 3. Business Address:

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* 4. Contact Telephone Numbers:

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* 5. Contact E mail Address:

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* 6. Current Insurer:

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* 7. Renewal Date:

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* 8. 2019 Renewal Premium:

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* 9. Expiry Policy Excess:

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* 10. Year Business Established:

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* 11. Exact Business Description:

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* 12. List of All Business Activities:

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* 13. Percentage of work with Under-18s:

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* 14. Percentage of overall activities at heights of over 1.5m:

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* 15. Annual Turnover:

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* 16. Annual Wages:

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* 17. Number of Staff:

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* 18. Number of claims in the past 5 years:

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* 19. Details of claims if any:

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* 20. Total insurer reserve on claim(s):

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* 21. Total paid out on claim(s):

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* 22. Do you have Health & Safety and Risk Assessments in place?