First Name
Last Name
Company
Website
Email Address
Phone
Country of registration
Years In Business
Number of Employees
0-50
50-100
150-500
500-1000
1000+
Do you have a Chief Security Officer?
Y
N
If NO, please indicate which position(s) are responsible for fraud and data security (a)
Do you have written fraud and theft procedures?
Y
N
Do you have adequate written INFORMATION SECURITY policies and procedures?
Y
N
Are background checks performed on all new employees?
Y
N
How often are bank accounts reconciled?
How many employees are permitted to control transactions from start to finish?
Revenue for the last financial year (in GBP)
Forecast Revenue for the current financial year (in GBP)
Forecast Revenue for the next financial year (in GBP)
% Revenue from the UK
% Revenue from Rest of the World
% Revenue from the USA/Canada
What Limit Do You Require Now (in GBP)?
Limit with current insurer (in GBP)
Premium with current insurer (in GBP)
Renewal Date
Please describe your business activities and any other specific insurance requirements you might need
I agree to your Terms & Conditions and the use of my personal information as explained in your Privacy Policy
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