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.