Pop Up Insurance Form

For a no-obligation quote, please complete this form. Your quote will be emailed to you within 3 working days.

Our insurer is unable to quote more than 30 days in advance. If you request a quote for a future period you will receive your quote 30 days prior to the cover start date.

For the purposes of your quote we will assume that you have not:

– had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending
– been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or insolvency proceedings
– had a proposal refused or declined
– had an insurance cancelled
– had a renewal refused
– had special terms imposed

If this is not the case, please provide details in the ‘Notes’ section below.

    Period of cover (starting)

    Period of cover (ending)


    Status of entity

    Any insurance claims paid or outstanding in the last 5 years?

    Material Facts – Tick those that apply

    Is there an intruder alarm?

    Accreditation of intruder alarm & Maintenance contract accreditation

    Under the sole control of proposer

    Alarm type

    Police Response

    Does the alarm incorporate confirmable technology

    Other Security Measures – Tick those that apply

    Public Liability Cover

    Employers Liability cover - Employer's Liability cover of £10,000,000 is automatically included at no extra cost

    Contact details

    W B Baxter Ltd,
    263 Cranbrook Road,
    Ilford, Essex,
    IG1 4TG


    Copyright @ 2023 W B Baxter Ltd.
    W B Baxter Ltd is authorised and regulated by the Financial Conduct Authority (FCA). Company Registration Number: 277519 | FCA Registration Number: 146480. If you have a complaint or dispute with us and are unable to resolve this to your satisfaction, we are obliged to offer you the Financial Ombudsman Service to help resolve this, please see the following link for further details: financial-ombudsman.org.uk