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PROFESSIONAL INDEMNITY & LIABAILITY INSURANCE ISSUE COVER REQUEST
Thank you for your interest in our Royal & Sun Alliance Insurance plc combined professional indemnity and liabilities insurance scheme, to enable cover to be issued please complete your details below:
   
Company Name (if applicable):
Contact Name (inc Title):  
Business Address:
Postcode:
Contact Number:
Date Business Established:
E-mail Address:
 
No. of Directors & practising Contractors:
No. of Other Staff
inc. non-practising directors:
Est. Annual Turnover:
Detailed Description of Business Activities:
What Date Do You Require Cover From:
Have You Been Previously Insured?
If YES, What is The Retroactive Date?
Professional Indemnity Limit of Indemnity:
Public/Products Liability Limit of Indemnity:
Confirmation of Annual Premium:
Method of Payment
If Other, please give details
N.B. No cover is in place until payment is received and you receive written confirmation of cover.
Please press the submit button to request cover