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Business Insurance Application Form
Please fill in all the mandatory fields marked with *
Cover Details
Property All Risks
Floor Size (sq. ft.)
Seating Capacity
Contents Sum Insured (HKD)
Stock Sum Insured (HKD)
Public Liability
Third party liability required?*
Third Party Liability Limit (HKD)*
Business Interruption
Do you require cover for loss of profits?
Estimated Gross Profit for First 12 Months (HKD)
Maximum Indemnity Period Required?
Sum Insured Required (HKD)
Do you require cover for Additional Expenditure?
Sum Insured (HKD)
Employees Compensation
No. of Employee - Management/Clerical
Estimated Annual Salary (HKD)
No. of Employee - Kitchen Staff
Estimated Annual Salary (HKD)
No. of Employee - Floor Staff
Estimated Annual Salary (HKD)
No. of Employee - Bar Staff
Estimated Annual Salary (HKD)
No. of Employee - Cleaners/Amahs
Estimated Annual Salary (HKD)
No. of Employee - Entertainers
Estimated Annual Salary (HKD)
No. of Employee - Others
Estimated Annual Salary (HKD)
Glass
Do you require cover against accidental breakage of glass?*
Description of Glass*
Replacement Cost of Glass (HKD)*
Money
Maximum Cash on Premises during business hours (HKD)
Maximum Cash in Transit (HKD)
Maximum Cash in locked safe in premises after business hours (HKD)
Maximum Cash in premises not in safe after business hours (HKD)
Maximum amount for crossed cheques, and other non-negotiable items (HKD)
Fidelity Guarantee
Do you require cover for dishonesty of employees?*
Description of Staff*
Sum Insured per person (HKD)
Any other information?
Cover Details
Name of Company*
Trading Name of Business
Company Address*
Business Nature*
Number of Employees*
Website of Company (if any)
Period of Insurance* (from dd/mm/yyyy to dd/mm/yyyy)
Details of Applicant
Full Name*
Corresponding Address
Phone Number*
Email*
Fax No.
Position Held in the Company
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