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Landowners by Yutree

Quote Form

Date of submission

Insurance broker

Contact Info

Your Name

Your Email

Your Contact Phone No.

Risk Information

Insured name and legal status (company or individual)

Insured address

Street Address Address Line 2 City County Post Code

Has any proposer, director or partner of the business ever been declared bankrupt, insolvent, liquidated, or the subject of bankruptcy or liquidation proceedings, or any insolvency process?

Yes

Has any proposer, director or partner of the business ever had a CCJ or Scottish equivalent awarded against them?

Yes

Has any proposer, director or partner of the business suffered any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending?

Yes

Has any proposer, director or partner of the business ever had a renewal refused, an insurance policy cancelled, or had special terms imposed?

Yes

Has any proposer, director or partner of the business ever received any HSE enforcement notices, improvement notices, or prohibition notices?

Yes

Description of land to be insured (select all that apply)

Arable land (for farming)

Grazing land

Woodland

Large areas of open countryside

Development site (undergoing development)

Development site (for future development)

Car park

Private road (well surfaced and maintained)

Private road (not well surfaced and maintained)

Communal residents' land (around estates etc.)

Other (please provide details below)

Other

Address of land

Street Address Address Line 2 City County Post Code

Acreage of land

If land cannot be measured in acres, please describe the size of the land

Hazards

Do the public have access to the land?

Yes

Are there any areas of open water or water course on or immediately adjacent to the land?

Yes

Are there any children's play areas or equipment on the land?

Yes

Are there any occupied buildings on the land?

Yes

Are there any unoccupied buildings on the land?

Yes

Are there any automatic barriers or gates on the land?

Yes

Are there any other hazards on the land such as steep drops, mines, quarries, fly tipping, other waste or hazardous materials etc?

Yes

Are there any trees on the land?

Yes

If the answer to any of the questions in the above section is 'Yes', then please provide full details including how the public are protected from the risks associated with the hazard and who is responsible for maintaining buildings, woodland, play equipment, barriers etc.

Cover

Current insurer

Number of years with current insurer

Renewal date / cover required date

Last renewal premium

Target premium (if different from the above)

Public / Products liability?

Yes

If yes, what is the limit?

£1m

£2m

£5m

£10m

Employers' liability (£10m)?

Yes

If yes, please list activities and wageroll:

Property (Material Damage for outside communal areas)

Yes

If yes, what is the limit?

£25k

£50k

Other

If yes, limit?

Further information

Claims

Please provide a full 5-year claims history.

If none, please specify here:

None

Public/Products liability

Property

Property & Landowners declaration - please tick to indicate you agree to the below

I agree that

there are no motorsports undertaken on the land

there are no equine activities on the land except for grazing and riding for pleasure purposes

there are no organised leisure activities undertaken on the land

there are no railway crossings on the land

there are no storage tanks or reservoirs at the site

there are no current or historic earthworks

there is no history of sinkholes in the area

all fences, gates, walls etc. which you are responsible for are in a good state of repair

Any additional information that relates to this risk

File upload

Drop files here or

Max. file size: 20 MB.

underwriting@yutree.com

01638 660 651

Yutree Underwriting

Yutree Insurance Ltd is authorised and regulated by the Financial Conduct Authority.

Registered office: 15 Kings Court, Newmarket, Suffolk, CB8 7SG

Registered in England No. 07718776

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