Commercial Combined Covid-19 (Coronavirus) Business Interruption Notification/Reporting Form

COVID-19 BUSINESS INTERRUPTION CLAIMS

Commercial combined covid-19 (coronavirus) business interruption notification/reporting form. Please answer all questions as fully as possible Please complete in BLOCK CAPITALS throughout and tick boxes where appropriate.

Contact Name
First Last
Email
Policy Number
Renewal Date
Insured Business Name
Full Address
Phone Number
Are you VAT Registered?*
- Yes
- No
Do you have Business Interruption Cover ‘Included’ under Section F of your policy schedule?*
- Yes
- No
Has there been an outbreak of Covid-19 (Coronavirus) at your premises?*
- Yes
- No
Has there been an identifiable confirmed case of Covid-19 (Coronavirus) within 25 miles of your premises?*
- Yes
- No
Please provide a brief description of how Covid-19 (Coronavirus) has directly affected your business:*
Please provide a list of any increased costs you have incurred as a business directly due to the outbreak:*
Financial Impact Assessment - MARCH 2020
Normal Revenue or Rental Income Figures* % reduction estimated as a direct result of the outbreak**
* The baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** The % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Financial Impact Assessment - APRIL 2020
Normal Revenue or Rental Income Figures* % reduction estimated as a direct result of the outbreak**
* The baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** The % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Financial Impact Assessment - MAY 2020
Baseline Revenue or Rental Income Figures* % reduction estimated as a direct result of the outbreak**
* The baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** The % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Financial Impact Assessment - JUNE 2020
Baseline Revenue or Rental Income Figures % reduction estimated as a direct result of the outbreak
* the baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** the % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Financial Impact Assessment - JULY 2020
Baseline Revenue or Rental Income Figures* % reduction estimated as a direct result of the outbreak**
* The baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** The % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Financial Impact Assessment - AUGUST 2020
Baseline Revenue or Rental Income Figures* % reduction estimated as a direct result of the outbreak**
* The baseline revenue or rental income figures should be either the corresponding figures from previous years or where possible based on your figures for actual bookings for the months in question. ** The % reduction can only be a best estimate but we do need to establish what the likely impact on the business is currently going to be based on the current situation, we appreciate this may change as the situation develops.
Please provide your confirmed business turnover for the last three years
2017 2018 2019
To the best of your knowledge please confirm what government assistance you currently expect to receive as a business in relation to the Cover-19 situation (business rates, holiday grants etc)*
If you provide written terms and conditions of service to your clients, please provide us with a copy
Either upload below or email them to mail@naturesave.co.uk
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2017	2018	2019

Commercial Combined Covid-19 (Coronavirus) Business Interruption Notification/Reporting Form

COVID-19 BUSINESS INTERRUPTION CLAIMS

Either upload below or email them to mail@naturesave.co.uk