@Title

Honesty's the best policy

Please take extra care when answering all questions. The information you provide should be as accurate as possible, and complete to the best of your knowledge. Failure to do this could affect your insurance policy. For further detail, please read the Duty of Disclosure section below.

Policy start date

RFQQuoteOrRenewal

TodaysDate

ThirtyDaysAfterTodaysDate

What date would you like your cover to start?

Your details

Please enter the full registered name of your business as it appears on your business documents such as your bank account, letter heading, invoices or business cards as this will be shown on your insurance documents.

Business name (if trading as company) or full name (if applying as individual)

Title

First Name

Surname

Correspondence Postcode

Please select one of the following addresses:

Address line 1

Address line 2

Address line 3

City / Town

County

Email Address

Work phone number

Mobile phone number

From time to time we'd like to tell you about other products or services we provide that we feel may be of interest you. If you would like to discover what else we could offer you, please let us know how you would prefer to be contacted.

Email

Phone

SMS

Post

You can opt out of marketing communications at any time either online, by clicking on the unsubscribe link at the bottom of any emails we send or by contacting us.

Important Information

Before proceeding, please read the following sections detailing your ‘Duty of Disclosure’ to provide accurate information. We also include details on ‘How we use your data’ in order to provide you with our services. If you have questions please call us on the number above.

Duty of Disclosure

How we use your data

To provide our services, we will collect and use information about individuals such as;

their name and contact details;
special categories of personal data (e.g. health information); and
information about criminal convictions and offences.

The purposes for which we use personal data may include arranging insurance cover, handling claims, for crime prevention and detection and for marketing.

More information about our use of personal data is provided in our Privacy Notice. You can also request a copy of our Privacy Notice by contacting dataprotection@marsh.com. We recommend that you review this notice.

Providing the services may involve the disclosure of personal data to third parties such as insurers, reinsurers, loss adjusters, premium finance providers, sub-contractors, our affiliates and to certain regulatory bodies who may require your information themselves for the purposes described in our Privacy Notice.

Depending on the circumstances, the use of personal data described in this notice may involve a transfer of data to countries outside the UK and the European Economic Area that have less robust data protection laws. Any such transfer will be done with appropriate safeguards in place.

Where you are providing us with information about a person other than yourself, you agree to notify them of our use of their personal data and, where necessary obtain their consent to our use of certain special categories of personal data. You agree that our provision of the services to you is conditional on you providing such notices and obtaining such consents. Where the consent of such third party is required, they may withdraw any such consent at any time but if consent is withdrawn then we may be unable to continue to provide services to them (and possibly you), and this may mean that we are unable to process enquiries or claims or that the relevant insurance cover will stop.

This is a summary of how we use your data. For further guidance, please read the document entitled “Terms of Business” or refer to our Privacy Notice.

Do you confirm that you have read and understand your duty of disclosure and requirement to make a fair presentation of the risk?

Yes

No

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0333 015 6629

0333 015 6629

Your Electrical Contractors Quote

@Title

Honesty's the best policy

Policy start date

Your details

Important Information

Duty of Disclosure

How we use your data

Completely secure

Have a question, need some help or information?

@Title

Free, no obligation insurance health check

Useful Links

Legal

phone 0333 015 6629

0333 015 6629

Your Electrical Contractors Quote

@Title

Honesty's the best policy

Policy start date

Your details

Important Information

Duty of Disclosure

How we use your data

Completely secure

Have a question, need some help or information?

@Title

Free, no obligation insurance health check

Useful Links

Legal

0333 015 6629