Please print, complete, sign and fax back to UK Tel: +44 (0) 117 9822229
 

 

Please keep a copy for your records.  If you cannot fax please post to:
1st Move International Limited. International House, Chittening Industrial Estate,
Avonmouth Bristol BS11 0YB

PROPOSAL - HOUSEHOLD GOODS/PERSONAL EFFECTS (NON-ACCOMPANIED)

 

Agency (Block letters)       1ST MOVE INTERNATIONAL LIMITED.
Agency Ref

 

 Policy Number

 

 

IMPORTANT - PLEASE COMPLETE IN BLOCK LETTERS AND GIVE DEFINITE ANSWERS TO EACH QUESTION

 

  Full Name of  Proposer  (You the customer)


 

 

 

 

 Full name of receiver overseas (If different)

 

  UK Address

 

 

  Postcode
  UK Tel. Number

  Overseas Address

 

 

  Postcode
  Overseas Tel Number.

 

Please note that when completing your insurance values, the correct value for each item insured is listed. Failure to give the correct value in this proposal will result in the Underwriters applying an average percentage to the value, if your goods are underinsured. For example: if an item of furniture is listed as £500 when in fact it is worth £1,000 and your claim is for £1,000 then the Underwriters will average out your claim due to underinsurance, and the difference can be significant.

 

DECLARATION

           I declare that the details herein are correct according to the best of my knowledge and belief, 
and agree that the particulars and statements given shall form the basis of the contract
between us.  I agree that every item requiring insurance is listed overleaf with the correct
quantities and values listed.  I further agree that if correct values are not listed and my effects
have been underinsured, I acknowledge that any claim will have an average applied. 
I declare that I have read and understood all conditions contained within this proposal. 
I understand that any owner packed items will be covered for loss and theft only and the policy
does not include breakage, etc as per the Owner Packed clause contained within this proposal.

 

 

  Proposer / Customer Signature

  Date



 

N.B. All material facts must be disclosed. Failure to do so could invalidate the Policy. A material fact is one that would be likely to influence an Underwriter in the assessment and acceptance of the proposal. If in any doubt as to whether a fact is material then it should be disclosed. You should keep a record (including copies of letters) of all information supplied to Underwriters for the purpose of entering into the contract. A copy of the completed proposal form will be supplied by Underwriters on request within three months of completion of the proposal.


 

Please print, complete, sign and fax back to UK Tel: +44 (0) 117 9822229

Please keep a copy for your records.  If you cannot fax please post to:
1st Move International Limited. International House, Chittening Industrial Estate,
Avonmouth Bristol BS11 0YB

INVENTORY OF HOUSEHOLD GOODS/PERSONAL EFFECTS (NON-ACCOMPANIED)

(This inventory will form part of the Policy when issued)

 

All property should be insured for its full replacement value at destination. Failure to do so will result in claims being reduced proportionally. Any antique articles must be separately declared and valued, and are subject to special rates to be agreed.

Item Description

Qty

Value each

Total Value

Please see Example below to ensure form is completed correctly:

 

 

 

Sofas

2

£500

£1,000

Dining Chairs

4

£25

£100

CD's

50

N/A

£500

DVD's

10

N/A

£100

Clothing

Various

 

£500

 

 

 

 

Please Complete, following example above, listing every item requiring insurance:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Carried forward to continuation sheet

 

 

 

 

 

 

 

Total Value Insured

 

 

 £

 

 

 

 


 

 

Please print, complete, sign and fax back to UK Tel: +44 (0) 117 9822229

Please keep a copy for your records.  If you cannot fax please post to:
1st Move International Limited. International House, Chittening Industrial Estate,
Avonmouth Bristol BS11 0YB

INVENTORY OF HOUSEHOLD GOODS/PERSONAL EFFECTS (NON-ACCOMPANIED)

(This inventory will form part of the Policy when issued)

 

All property should be insured for its full replacement value at destination. Failure to do so will result in claims being reduced proportionally. Any antique articles must be separately declared and valued, and are subject to special rates to be agreed.

Item Description

Qty

Value each

Total Value

Please see the example on form above to ensure this form is completed correctly:

 

 

 

Brought Forward from previous sheet