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Toggle Navigation
About Us
History
Values
Acquisitions
Products
Aviation
Delegated Authorities & Programmes
Employee Value and Protection
Marine
Non Marine
Product Recall
Professional Indemnity
Special Risks
Sports & Leisure
Claims
Careers
News
Contact
Company Renewal Updates Form
Aqueous
2025-09-09T09:07:13+01:00
Company Renewal Updates Form
Please fill in this form and we’ll come back to you shortly.
Company Client Information
Company name
*
Contact name
*
Email address
*
Phone number
*
Company Information
Insurance History
Have you ever had an insurance proposal or renewal declined, cancelled, or refused?
*
Yes
No
Have you ever had special terms, restrictions, or conditions imposed on your insurance cover?
*
Yes
No
Directors & Officers
Has any director ever been convicted of, or charged (but not yet tried) with, a criminal offence?
*
Yes
No
Has any director ever been declared bankrupt, or been involved with a business that went into liquidation, was dissolved, or had a receiver appointed?
*
Yes
No
Have you, or any director, officer, trustee, or employee, been subject to an official or regulatory investigation?
*
Yes
No
In the last three years, have any regulatory bodies or auditors raised concerns or issued negative findings about the business?
*
Yes
No
Company Structure & Governance
Have there been any changes to the company’s structure or ownership in the last 12 months?
*
Yes
No
Are any changes to the company’s structure or ownership planned?
*
Yes
No
Are there any planned mergers or acquisitions?
*
Yes
No
Have any directors or trustees resigned or been replaced in the last 12 months?
*
Yes
No
Legal, Regulatory & Tax Matters
Has the business been involved in any legal disputes, prosecutions, or tax enquiries?
*
Yes
No
Are you aware of any circumstances that could give rise to a legal dispute, tax enquiry, or criminal prosecution?
*
Yes
No
If yes please provide additional information:
Property
Have you made any new purchases in the last 12 months?
*
Yes
No
If so, please provide additional information:
Have there been any changes to your business premises?
*
Yes
No
If so, please provide additional information:
Do you have any business equipment on lease agreements?
*
Yes
No
If so, please provide additional information:
Public Liability
Have you made any changes to your business activities?
*
Yes
No
Have you had any incident in the last 12 months that you think will lead to a claim against your policy?
*
Yes
No
Have you had any H&S Investigations?
*
Yes
No
Have you had any RIDDOR reportable incidents?
*
Yes
No
What has your turnover been for the last 12 months?
*
Did you make a profit (that is, a net profit after tax) in the last 12 months?
*
Yes
No
If you made a profit, how much?
*
If yes to any of the above please provide additional information:
Turnover
Turnover split by activity
Activity
Existing
Projected
Activity
Existing
Projected
Activity
Existing
Projected
Activity
Existing
Projected
Activity
Existing
Projected
Employers Liability
Total number of employees
*
What are your total annual wages?
*
Have you made any redundancies in the last 12 months?
*
Yes
No
Do you have any redundancies planned in the next 12 months?
*
Yes
No
How many employees have left the company in the last 12 months (either voluntarily or non-voluntarily)?
*
If yes to any of the above please provide additional information:
Wages
Wages split by role
Wages
Existing
Projected
Wages
Existing
Projected
Wages
Existing
Projected
Wages
Existing
Projected
Wages
Existing
Projected
I consent to Lime Street Brokers processing my information in accordance with their
privacy policy
and contacting me to discuss the information I have provided.*
Thank you for submitting, a member of the team will be in touch.
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