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Public Liability Insurance

Name  
Email  
Phone  
What is primary purpose of your business?  
     
What is your estimated turnover over the next 12 months?  
     
Please state your required level of cover i.e. $100,000 , $1m etc?  
     
Have you suffered any losses in the past 3 years
( insured or uninsured losses)
  Yes
     
Standard coverage is provided for 12 months from inception of cover, please advise if your require coverage for less than 12 months with exact dates of coverage?