Third Party Liability Insurance Form

ADDRESS OF THE INSURED RISK
DETAILS OF THE INSURED RISK (compete the fields of your interest)
Is the building proprietary or rented ? Have you sublet part of the area / building ?
Does your personnel work in other places apart from the above mentioned? (maintenance,. facilities, travel, inspections)
Do you use and store radioactive substances and/or devices and/or explosive materials and /or chemicals ?
If the required insurance refers to the below mentioned uses, please answer the questions :
Α. Churches, Cinemas, Theaters, Restaurants, Bars, Patisseries , Café etc
Β. Clubs, Gyms
Γ. Schools *
*Please state the details separately for every education level (infant, elementary, junior high, high school etc)
EXTENSIONS OF COVER
Do you wish to cover your liability towards the following cases ?
MAXIMUM LIABILITY LIMITS
INSURANCE PERIOD