Product Liability | Quotation

Personal Details

Risk Details 1

Risk Details 2

Personal Details

Insurance Company

First Name / Corporate Name

Last Name

Mobile No.

Email Address

Which FBBI branch do you want to be served from?

Period of Insurance

Insurance Start Date

Insurance End Date

Building Infomation

Name of Building

Location (L.R.Number)

Use of Building

Street/Road

Area/Estate

Town Code

Earth Quake Zone

Business/Trade/Occupation

Explain What Your Business Entails

Please Specify Any Other Business Entails.

Give details of products subdivided into different categories (range) if more than one type of product is Involved

Describe the purpose or use of the product (s) 1

Product Name

Describe Purpose

Use as Component

What type of products and by which industry?

Assembled by another firm(or person)

Give Details?

File Upload

Note:- Brochures or leaflets describing the products can be enclosed if available.

Browse

* Allowed file formats (xls, xlsx, pdf, jpg, jpeg, doc, txt, docx, png)

If you incorporate parts manufactured elsewhere for any of the above listed products, wholly or partly, including raw materials, state the part or component and from where they are sourced

Are any of your products sourced locally or abroad?

If so, Please give details

Are any of your Products Exported ?

Note: This cover excludes exports to the USA and Canada.

Country Details 1

Country

Estimated turnover

Are any of the products supplied for use in connection with:

Aircraft, aerospace equipment or aerial devices of any kind?

Pharmaceuticals?

Offshore Platform and Rigs?

Since when have you been engaged in manufacturing/supplying these products?

Do you enter into any agreement or undertaking to indemnify or compensate suppliers of materials or components or subcontractors or processors in respect of any injury or damage?

What type of packaging do you use?

Do you manufacture the packaging materials?

where are the packaging/containers acquired?

Do you give any written guarantee or conditions of sale with or in respect of any of your products by

By printing on the package /product

By a separate leaflet or brochure?

please supply sample wordings

Are there any quality control measures in place with regard to the product?

please explain

Are there any Statutes, Laws or Bylaws that govern your operations with regard to the product proposed for insurance?

Statutes, Laws or Bylaws Details 1

Law

Name, Title or Heading of Law

Do you operate in compliance with this Laws?

Please Specify

Limits of liability required:

All claims arising during the Period of Insurance

Estimated Annual Turnover

Product Liability Quotation

Personal Details

Period of Insurance

Building Infomation

Describe the purpose or use of the product (s) 1

File Upload

Note:- Brochures or leaflets describing the products can be enclosed if available.

Note: This cover excludes exports to the USA and Canada.

Country Details 1

Are any of the products supplied for use in connection with:

Statutes, Laws or Bylaws Details 1

Limits of liability required: