Application Form

    Pre-Qualification Questions

    Are you a limited company, registered in England, Scotland, Wales or NI?
    Have you been registered for more than 2 years?
    Are you VAT registered?
    All you an all trades contractor, capable of carrying out all aspects of building reinstatament?
    Do you carry the relevant levels of insurance?
    Do you have an up to date H&S Policy, in accordance with the most current legislation?

    Contact Details

    Trading Name
    Registered Name (if different)
    Director/ Owner Name(s)
    Name of Person Making Application
    Business Contact Number
    Direct Contact Number
    E-mail Address
    Web Address
    Company Reg Number
    VAT Reg Number
    Business Address

    Insurance Details

    Employers Liability: £5,000,000 min
    Public Liability: £2,000,000 min
    Contractors All Risks: £250,000 min
    Number of PAYE Staff
    1-1011-5050+
    Do you CRB Check your Staff?
    YesNoN/A
    Number of Sub-Contractors
    1-1011-5050+

    Service Provider

    General Reinstatement
    YesNo
    Drying & Strip-out
    YesNo
    Out of hours call out
    YesNo
    Asbestos Sampling
    YesNo
    Asbestos Removal
    YesNo
    Commercial
    YesNo

    Certifications & Accreditations

    Gas Safe
    YesNo
    CHAS
    YesNo
    NICEIC
    YesNo
    CIOB
    YesNo
    IOSH/ NEBOSH
    YesNo
    Drying Qualification

    Membership Preferences

    Please provide details of the postcode areas you cover in the text box below.
    Here at Insurance Builders 4 U, we deal with all aspects of insurance reinstatements, please select yourp preferences I capabilites from the below:
    Total Reinstatement
    YesNo
    New Build - From Plan
    YesNo
    Commercial
    YesNo
    Capabilites

    Financial Assessment

    Year 1: turnover (most recent)
    Year 1: % of turnover related to insurance work
    Year 2: turnover
    Year 2: % of turnover related to insurance work
    Year 3: turnover
    Year 3: % of turnover related to insurance work
    Please provide details of any insurance networks that you currently, or have previously, worked on

    References

    Please provide details of two references that we can contact in support of your application.
    Reference 1 Name
    Reference 1 Relation / Position
    Reference 1 Company (if applicable)
    Reference 1 Contact Number
    Reference 1 Email Address
    Reference 2 Name
    Reference 2 Relation / Position
    Reference 2 Company (if applicable)
    Reference 2 Contact Number
    Reference 2 Email Address

    Additional Information

    Please provide any additional information that you feel will support your application

    Declaration

    I hereby declare that the information provided within this application form is true and correct to the best of my knowledge and belief. I understand that any willful dishonesty or attempt to mislead will render for refusal of this application.

    I understand that submission of this application does not guarantee acceptance as an Insurance Builders 4 U Approved Contractor.

    By submitting this application I understand and authorise Insurance Builders 4 U. to carry out the due diligence aspects required including (if required) a company credit check.