For further details of our Contingent Strike Insurance protection please complete our Indication Questionnaire below, or click here to contact us.

You can also view a Proposal form in pdf format by clicking here. If you want to download this for viewing later, right click here and select 'Save Target As...' from the pop up menu which appears. You can then save the form to your computer.

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Name of Assured
E-mail address
Address of Assured
Post code / Zip of Assured
Estimated annual gross revenue
Estimated annual gross profit
Brief description of Assured's operation
Name and address of supplier(s) or customer(s) against whom cover is sought
Details of goods or services being supplied to or by Assured
Past strike experience of nominated supplier or customer and impact on Assured’s operation
Assured’s stockpile or alternative suppliers in the event of a strike
Sales peaks and / or troughs during the year
Period of Insurance
Period of Indemnity
Sum to be Insured