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  • Why Security Insured?
    • About Us
    • Fenchurch Law
  • Who We Cover
    • MANNED SECURITY
      • Close Protection Insurance
      • Door Supervision Insurance
      • Event Security Insurance
      • Security Guard Insurance
      • Dog Handler/Canine Security Insurance
    • SECURITY INSTALLATION
      • Access Control Insurance
      • CCTV Installers Insurance
      • Fire Alarm Installers Insurance
      • Intruder Alarm Installers Insurance
      • Locksmith Insurance
      • Sprinkler Insurance
  • What We Cover
    • Business Insurance
      • Public Liability Insurance
      • Employers Liability Insurance
      • Property Insurance
      • Motor Fleet Insurance
      • Commercial Legal Expenses Insurance
      • Directors & Officers Insurance
      • Personal Accident Insurance
      • Cash in Transit Insurance
    • Security Insurance Cover Extensions
      • Inefficacy & Contractual Liability
      • Products Inefficacy
      • Wrongful Arrest
      • Loss of Keys
      • Fidelity Guarantee
      • Financial Loss
      • Professional Indemnity Insurance
    • Health Insurance
      • Company or Group PMI
      • Individual PMI
      • International or Expat PMI
    • Life Insurance
      • Term Life Insurance
      • Key Man Insurance
      • Critical Illness Insurance
      • Group Life Insurance
      • Protection Insurance
  • Useful Links
    • Full Proposal Form
    • Examples of Claims
    • Report A Claim
    • FAQs
  • Knowledge Hub
  • Contact
Security-Insured-Agency-Application-FormSeb2021-05-29T18:50:43+01:00

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  • Producing Broker Application Form


    The purpose of this form is to fulfill our regulatory obligations by performing a process of vetting and approval of your business before we enter into a contractual relationship with you. We wish to work only with those who are committed to our standards and we will undertake due diligence to ensure this.

    Throughout our operations we maintain systems and controls for compliance with applicable requirements and standards under regulatory guidance as set out by the Financial Conduct Authority. Importantly, this includes policies and procedures for countering the risk of becoming involved in financial crime. We maintain a policy of zero tolerance towards bribery and corruption in all forms, whether directly or through third parties.
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  • Company Details

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  • Please list below the name of Key Personnel, Principals, Directors, Partners or controllers in your business (a controller is a person who: (a) holds 20% or more of the shares or voting power in your firm, or in a parent of your firm; or (b) holds shares or voting power in your firm, or any parent, as a result of which the person is able to exercise significant influence over the management of your firm):
  • Person 1

  • DD slash MM slash YYYY
  • Person 2

  • DD slash MM slash YYYY
  • Person 3

  • DD slash MM slash YYYY
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  • Regulatory Information

  • Additional Company Information

  • Professional Indemnity

    PLEASE NOTE THE APPLICATION WILL NOT BE PROCESSED WITHOUT THIS INFORMATION
  • Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB.
  • Sales Information

  • Please provide details of the Gross Written Premium (GWP) for the types of general insurance that you currently provide:
  • Business Continuity Planning

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  • Security Insured Products

  • Bank Details

  • Business Account Details

  • Client Money/Fiduciary Funds Account Details (if applicable)

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  • Security Insured Products

  • Has any Director, Partner, Proprietor or Manager personally or by association: If any of the below questions are answered as ‘Yes’, please provide further details in the bo x provided.
    • I hereby declare and affirm that I am duly authorised to submit this application and make this declaration on behalf of the Producing Broker (see ‘Terms’ below).
    • I declare on behalf of the Producing Broker that, to the best of my knowledge and belief, the information contained in and attached to this application information is accurate, complete, upto-date and purports to be comprehensive and not misleading.
    • I acknowledge and agree on behalf of the Producing Broker that any information provided pursuant to the application constituting personal data may be stored at and/or processed in accordance with our Privacy Statement (available on request).
    • I acknowledge that, where circumstances lead Security Insured to suspect bribery, corruption, or other financial crime in relation to business with the Producing Broker, additional due diligence may be carried out and further steps taken, including, the notification to the relevant authorities, status and credit checks using credit reference agencies, and other background checking, as deemed appropriate.
    • undertake to immediately advise Security Insured of any material changes to information contained within this questionnaire, being matters of which Security Insured would reasonably expect notice.
  • Security Insured is a trading style and Appointed Representative of Movo Insurance Brokers Ltd.

    Movo Insurance Brokers are authorised and regulated by the Financial Conduct Authority, authorisation number 515938.

    Registered Office: 63 Cotmandene Crescent, Orpington, Kent, BR5 2RA Registered in England No: 07176446
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  • Summary of Completed Form

    Please check all details are correct before submiting

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We always strive to provide all of our clients and anyone that contacts us with the best possible level of customer service. If you are happy with the level of service you have received, please do tell others or review our services on Google or Facebook.

If you have not had a great experience, please also let us know so that we resolve any issues there may be outstanding to your satisfaction.

Contact Us

First Floor, 30 High Street
Chislehurst
Kent
BR7 5AS

Phone: 0800 7797 880
Email: info@securityinsured.co.uk

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Security Ins Broking Ltd Trading as Security Insured is an Appointed Representative of Movo Partnership Ltd who are directly authorised and regulated by the Financial Conduct Authority with registration number 823503.

Registered Office: First Floor, 30 High Street, Chislehurst, England, BR7 5AS Registered in England No: 11544243.


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