Plate Glass Quotation

Personal Details

Proposer Type

Proposer First Name

Proposer Middle Name

Proposer Last Name

Mobile No.

Email Address

Which Bunna Insurance S.C. branch do you want to be served from?

Are you the sole occupant of the building?

Are the premises situated at the corner of a street?

All fixed External glass in the business portion including Vitrolite, Marmorite,etc.?

All fixed Internal glass in the business portion including Mirrors, Shelves and Showcases?

Is any of the glass within 18 inches of the pavement?

Is the glass mentioned above free from cracks and other defects?

Are there any shutters?

Are any of the squares of Glass moveable?

Have breakages occurred during the last twelve months?

Is the glass exposed to any special risk?

Are the premises empty?

Is the woodwork of this shop front, and the window frames in good and sound condition?

1. Glass Details

Type of Glass

Floor & Position

Is the Glass plate or sheet or leaded lights land

Position

Number of Squares or Panes

Size of Each Square or Pane (in centimeters)

Height

Width

Thickness

Area of each square / pane

Rate per square/pane(in sq. meters)

Value

Sum Insured

Remove

Is it desired to cover the cost of painting, lettering or other ornamentation on the glass?

Accidental breakage of Neon signs?

Damage to the Window frames of the shop front?

Accidental breakage of fluorescent lighting filaments (other than tubes) and Electric Light Bowls?

Damage to window displays by impact or falling glass?

Do you require Riot and Strike extension?

Plate Glass Quotation

Personal Details

Period of Insurance

Risk Details

Building Risk details 1 Remove

Building Details

Construction Details

Does the glass to be insured comprise of

1. Glass Details

Size of Each Square or Pane (in centimeters)

Is cover required in respect of