Quotation Request Build-Zone Client Project Structural Cover Survey Contacts Professional Teams Phasing Unit Schedule Supporting Files BZSS Sign Off Cover Details Client DetailsAre you completing this form on behalf of a client? YesNo Are you an FCA regulated insurance broker? YesNo Please ensure you have signed into your account at https://go.build-zone.com/login before proceeding.If you do not have an account with Build-Zone please register at https://go.build-zone.com/broker It’s a requirement of the insurance that the form is completed by the client unless otherwise done so by an FCA authorised and regulated insurance broker. We kindly request that your client completes this application form themselves. Is this a Wholesale risk to you?Answer YES if you are dealing with another Broker. Answer NO if you are dealing directly with the client. YesNo Please confirm the legal business name of the Retail Broker you are dealing with Please confirm that the Retail Broker is FCA Regulated and you have a signed TOBA in place with them YesNo Are you completing this project as a private individual, or in a company name? Private Individual Developer Your full name -- Mr Mrs Miss Ms Dr Prof. Capt. Lord Lady Major Rev. Master Exec(s) of Mx Principal company nameYour principal business name. If you are using an SPV for this project you can detail that name in a subsequent question. Principal Company Registration Number Has a subsidiary Special Purpose Vehicle (SPV) been created for this project? YesNo Business name for this project's SPV Your role in this project Private Individual Architect Contractor Developer Developer and Contractor Housing Association Project Manager Contact name Contact phone number Contact email address Email Email enter again Contact address Line 1 Line 2 Town/City County Postcode Enter address manually or Enter address manually Use address lookup Are you responsible for providing site access to surveyors? YesNo If applicable, select your Build-Zone executive Not applicable Ash Poore Ben Walker Bob Stembridge Joe Gooden Russell Turner Stephen Gordon Zaf Choudry Have you ever been declined or removed from a warranty scheme or provider? YesNo Project DetailsProject nameThe name or reference by which your identify this project Project address Line 1 Line 2 Town/City County Postcode Enter address manually or Enter address manually Use address lookup Project location England Scotland Wales Northern Ireland Isle of Man Channel Islands Development type Residential - Private Dwelling House Residential - Block of Flats Commercial - Units Commercial - Block Mixed Use - Block Custom Build Do you or a close family member plan to live in this property for at least 12 months? YesNo Notice for self-buildersIf you or a close family member plan to live in this property for at least 12 months, please visit www.selfbuildzone.comfor a policy better suited to your circumstances. Brief description of Works Type of works New build Conversion Extension Refurbishment Combination of above Intended end-use of the property Build-to-Rent Hotel Office Residential Retail Social and Housing Association Student Accomodation Warehouse Mixture of above Stage Not started Building Regulations submitted Substructure designed Piling being designed Piling being carried out Piling complete Foundations Dug - No Concrete Poured Foundations - Concrete Poured DPC DPM and Oversite Wall Plate Timber Frame Erect Structural Integrity Works Complete Roof On / Wind and Water Tight First Fix / Pre-plaster Second Fix Completed Details of how the project is being funded Planning Application Reference Number Will the project be designed by an Architect? YesNo Is this a Permitted Development Project (PDR)?Permitted Development Rights are a national grant of planning permission which allow certain building works and changes of use to be carried out without having to make a planning application. YesNo Is the project Phased? YesNo Number of single-unit private dwelling houses (Terraced, Bungalow, Semi-detached, Detached) Number of Single-Unit Commercial Buildings Multi-Unit Blocks – Residential OnlySeparately detail each Block and the number of Residential Units within. Use the (+) button to add more Blocks. Your Reference (eg. Block #1)Number of Residential Units Multi-Unit Blocks – Commercial OnlyFor commercial-only blocks, separately detail each block and the number of Commercial Units within each. Use the (+) button to add more Blocks. Your Reference (eg. Block #1)Number of Commercial Units Multi-Unit Blocks – Mixed Residential and CommercialSeparately detail each Block and the Number of Residential/Commercial Units within. Use the (+) button to add more Blocks. Your Reference (eg. Block #1)Number of Residential UnitsNumber of Commercial Units Combined area of all storeys of all buildings (square metres)This needs to be the total floor area for all Housing Units or Premise’s inclusive of basements, plus any separately identifiable structures such as detached garages and/or outbuildings that you want to include cover for under this policy.Only know the area in square feet? Use this converter (link opens in a new window) Gross Development Value (GDV), if known. £ Would you like a quote for Building Control services from our "partnered" surveyor network (Approved Inspector)?If you are making separate arrangements for Building Control, one of our partnered surveyors will carry out a series of separate technical audits of the development for the purposes of the warranty.By using our "partnered" surveyor network for your Building Control you will benefit from having one of our surveyors on site to carry out the Warranty and Building Control inspections at the same time. YesNo If applicable, who is already providing Building Control on this project? ACT AIS (Approved Consultant Services) Approved Design C3 Design Approvals Ltd Cook Brown Building Control Jon Blake MC Plan Meridian Prime Construction Consultants Salus Stroma TA Group Total Building Control Other Local Authority Other - Provide details Building Control Reference Number Is the project being built under a Building Notice?This is a form of Building Regulation application intended for small works only. We suggest proceeding with caution. You will be building without a Plan Check as you have little design information or drawings. The cost of the warranty could increase using a Building Notice rather than a Full Plans application. YesNo Is any part of the Development on a sloping site? YesNo Is the project in an area associated with Flooding, Radon, Mining, Cheshire Brine or other Mineral Extraction? YesNo Start Date of building worksEstimate if works not yet started 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Completion Date for projectEstimate if work is ongoing 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 Structural DetailsNumber of storeys above ground (including ground floor) Number of storeys below ground Foundations Existing Piled Raft Strip Trench fill Underpinning Type of structural frame Concrete: Pre-cast Concrete: Concrete Blocks Concrete: Cast in-situ Concrete: Insulated Concrete Formwork (ICF) Steel Frame Brick and Block Stone Block: Lightweight Block Block: Concrete Block Block: Other Timber Frame: Off-Site Manufacture Timber Frame: Cut on-site Timber Frame: Bespoke Build (Post and Beam / Passivhaus etc.,) Timber Frame: Cross Laminated Timber (CLT) Timber Frame: Unseasoned Structurally Insulated Panels (SIPS) Modular: Cross Laminated Timber (CLT) Modular: LSG/Box Frame Modular: Structurally Insulated Panels (SIP) Straw Bale Rammed Earth Glass Mixed or other Mixed or Other - Provide details Type of structural or load-bearing wall Brick Cobb or similar Concrete: In-situ Concrete: Precast Concrete: Concrete Blocks ICF polystyrene block Straw bale Stone Structural Insulated Panels (SIP) Timber Other Other - Provide details Type of facade or cladding Brick Block and Render: Lightweight Block Block and Render: Concrete Block Block and Render: Render Board system Block and Render: Other Aluminium Glazed Curtain Walling Rainscreen Render and Tile/Slate cladding mixed Stone Timber Other Other - Provide details Are there any new areas of flat-roof?Please note any roof with less than a 10° pitch is considered to be a flat roof. YesNo Material used for the roof covering of the New Works Tiles Natural slate Felt or single membrane GRP Lead Zinc Sedum Thatch Mixed or Other Mixed or Other - Provide details Will there be balconies? YesNo Material used for balconies Steel Bolt-on Insitu Cast - Concrete Inset Juliet – Concrete Cantilevered Hung - Steel Cable Stacked Timber Mixture of the above Will there be terraces? YesNo Material used for terraces Single Ply Membrane Hot Rolled Green Roof Lead GRP Cover RequirementsTotal Reinstatement Cost of the New WorksHow much would it cost (in terms of materials and professional labour) to reinstate all new works of the project if you suffered a total loss (eg. fire) when nearing completion? You need to consider the cost of removing debris and professional fees in arriving at this figure.Including materials, labour, professional fees, debris removal and VAT £ Total Reinstatement Cost of the Retained Existing StructuresHow much would it cost (in terms of materials and professional labour) to reinstate the existing structure. DO NOT include the value of the land. If you have buildings insurance already in place for an existing structure, you must check that the insurance company is prepared to continue covering it while you self-build or self-manage the proposed works. Many home insurers exclude cover on properties undergoing renovation, alteration or conversion.Including materials, labour, professional fees, debris removal and VAT £ Period of cover required for this warranty 10 years 12 years Loss of Rent figure, per annum £ Indemnity Period Not applicable 12 months 18 months 24 months 36 months 48 months Survey Contacts This is not mandatory at this stage but will be required before the policy is purchased. Contacts for site access NameRoleOrganisationPhoneEmail Professional Teams Only the Developer and Main Contractor names are mandatory at this stage but any additional information can help us to provide a faster quote. Developer Name Developer's Company Registration Number ----------------------- Main Contractor Name Companies House Reg No ----------------------- Architect Name Companies House Reg No ----------------------- Structural Engineer Name Companies House Reg No ----------------------- Project Manager Name Companies House Reg No ----------------------- Sub-contractors NameCompany Reg. No.Work Package Phasing This is not mandatory at this stage but any additional information can help us to provide a faster quote. Project PhasingIf the project is phased, provide details of units and phasing Phase NumberStart DateExpected CompletionNo. / Type of UnitsSum Insured per Phase £ Schedule of UnitsList all unitsYou should enter only whole numbers for the size and costs, decimal point accuracy is not required. Please note that the total reinstatement cost of the units should be the same as the figure you entered on the questions in the Cover tab. Unit RefSale PriceFloor Area (m²)Type of UnitReinstatement Cost Existing StructureCost of Conversion WorkReinstatement Cost if New Build £ - select - DetachedFlatMaisonetteSemi-detachedTerrace £ £ £ Upload Supporting Files For This Application This is not mandatory at this stage but any additional information can help us to provide a faster quote. Architectural PlansMaximum file size 5Mb Engineering PlansMaximum file size 5Mb Design Access Statement (DAS)Maximum file size 5Mb Stage 3 ReportMaximum file size 5Mb Site Investigation ReportMaximum file size 5Mb Structural Report for a ConversionMaximum file size 5Mb Photograph of Existing Structure(s)Maximum file size 5Mb Building Control Completion CertificateMaximum file size 5Mb BZSS Sign OffBuilding Control Plots and dates received Electric (Part P) Plots and dates received Gas/Oil (Part M) Plots and dates received Drainage (Part H) Plots and details received HETAS Plots and dates received OpenGI Status Clear Pending Outstanding Surveys All Received Outstanding Remediations Clear Outstanding Outstanding but excluded Cover Details Set IPT @ % £0.00 Set VAT @ % £0.00 Total Premium (Net) £0.00 + IPT @ % £0.00 + Policy Fee £ £0.00 Total Premium £0.00 Total Commission £0.00 (Due From Broker) £0.00