Proposal Form - Security Industry
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Full name of Proposer including all trading names, group companies and subsidiaries that are to be covered by the policy
Telephone Number and Person to Contact
Email Address
Date Established
Please list the names, dates of birth and background of all the Company Directors/Partners including number of years experience in the Security Industry.
NameDate of BirthNo. of Years
Details of Experience
If you require Employers’ Liability cover, please supply your Employer PAYE Reference(s). (This information is mandatory. Employers’ Liability cover cannot be provided without it. Where you have more than one PAYE Reference, please advise each one making it clear which company they apply to). Further information can be found at
If you do not have a PAYE Reference, please confirm that you are exempt and give the reason.
Are you a member of any Regulatory Body or Trade Association?
If not already a member have you applied or is it your intention to apply for membership of any Regulatory Body or Trade Association?
Is your company an SIA Approved Contractor?
Yes  No
Are you and all your staff licensed by the SIA?
Yes  No