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(State names of all partners and trading name if not a limited company)
Address Line 1*:
Address Line 2:
Address Line 3:
Current/Previous Insurer or Broker Name:
How did you hear about Lycetts?*
Please state fully all activities in which you or your firm are involved:
Please confirm the full postal address where the equipment is kept overnight:
Is all equipment including Wood Chipping Machines kept in a self contained, locked building of standard construction (brick or stone) accessed solely by you?
If no, please provide details
Are there any additional security features to the premises, e.g. alarm, security lighting?
Have there been any incidents in the last 5 years, which have, or could have given rise to any claims under this section? If so, please provide details below
Date of Incident:
Is cover required for Wood Chipping Machinery?
If yes, please detail below and answer the following questions:
Description Including Model:
New for old or market value?
Insured Value (inc VAT if NOT registered):
Fitted with operational tracking system?
Please state the total new replacement value of your remaining equipment
Do you require this cover for plant and equipment hired in under contract?
What is the estimated annual amount paid in hire charges?
What is the maximum Single Article Limit of any one item hired in?
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f: +44 (0)191 232 1873