Click "Submit" after completion
AGENT REFERRAL
Compete if you are acting on behalf of the proposer
Relationship
Select?
Accountant
QS
Solicitor
Architect
Estate Agent
CRL
Other
Agent
Address
Postcode
Contact
Tel
Email
PROPOSER DETAILS
Name
T/as
Trade
Trading Since
Territory
Select?
UK ONLY
UK & ROI
ROI ONLY
UK & EU
WORLDWIDE
Sole Trader
Partnership
Limited
If Limited : Company Reference Number
Any Subsidiary Companies
Yes/No?
Yes
No
If yes..
PROPOSER CONTACTS
Address
Postcode
Tel
Fax
Mob
Email
Web
EXPERIENCE
Give details of your experience in your trade:
Tick if any claims in last five years :
If yes..
ACCOUNTANT
Name
Address
Postcode
Tel
Email
BOND (A)
Bond Detail (A)
Bond Type
Select Bond Type?
Performance Bond
Road Bond
Development Bond
Article 32 Bond
Article 161 Bond
Deferred Consideration Bond
Retention Bond
Advance Payment Bond
Maintenance Bond
New House Warranty
Contract Value
Bond Amount
Currency
Select?
Stirling
Euros
Start Date
Contract Period
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Months
Maintenance Period
1
2
3
4
5
6
7
8
9
10
11
12
<24
<36
Months
Warranty Period
0
1
2
3
4
5
6
7
8
9
10
11
12
Years
Bond Wording
Wording?
Not Yet Provided
Employer to Provide
Insurer to Provide
If the employer has provided you with a Bond Wording we will require a copy for the insurers to approve. You can email this to
quotations@wallace-group.co.uk
Contract Detail (A)
Contract Detail
Location Address
P/Code
Are You Main Contractor :
Bond Beneficiary (A)
Beneficiary
Address
P/Code
BOND (B)
Bond Detail (B)
Bond Type
Select Bond Type?
Performance Bond
Road Bond
Development Bond
Article 32 Bond
Article 161 Bond
Deferred Consideration Bond
Retention Bond
Advance Payment Bond
Maintenance Bond
New House Warranty
Contract Value
Bond Amount
Currency
Select?
Stirling
Euros
Start Date
Contract Period
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Months
Maintenance Period
1
2
3
4
5
6
7
8
9
10
11
12
<24
<36
Months
Warranty Period
0
1
2
3
4
5
6
7
8
9
10
11
12
Years
Bond Wording
Wording?
Not Yet Provided
Employer to Provide
Insurer to Provide
If the employer has provided you with a Bond Wording we will require a copy for the insurers to approve. You can email this to
quotations@wallace-group.co.uk
Contract Detail (B)
Contract Detail
Location Address
P/Code
Are You Main Contractor :
Bond Beneficiary (B)
Beneficiary
Address
P/Code
BOND (C)
Bond Detail (C)
Bond Type
Select Bond Type?
Performance Bond
Road Bond
Development Bond
Article 32 Bond
Article 161 Bond
Deferred Consideration Bond
Retention Bond
Advance Payment Bond
Maintenance Bond
New House Warranty
Contract Value
Bond Amount
Currency
Select?
Stirling
Euros
Start Date
Contract Period
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Months
Maintenance Period
1
2
3
4
5
6
7
8
9
10
11
12
<24
<36
Months
Warranty Period
0
1
2
3
4
5
6
7
8
9
10
11
12
Years
Bond Wording
Wording?
Not Yet Provided
Employer to Provide
Insurer to Provide
If the employer has provided you with a Bond Wording we will require a copy for the insurers to approve. You can email this to
quotations@wallace-group.co.uk
Contract Detail (C)
Contract Detail
Location Address
P/Code
Are You Main Contractor :
Bond Beneficiary (C)
Beneficiary
Address
P/Code
FINANCIALS
Profit And Loss (2 Years)
Extract the following information from your accounts:
Profit & Loss
Year 1
Year 2
Year End
Fixed Assets
Current Assets
Current Liabilities
Net Liabilities
Other Liabilities
Net Assets
Balance Sheet (2 Years)
Balance Sheet
Year 1
Year 2
Year End
Sales
Expenses
Profit/Loss
This information will require verification later:
FUNDING
Funding: Banking/Facilities
Summarise your current facilities:
Banking/Facilities
Balance £
As At:
OverDrafts
Loans
Credits/Savings
Un-Released Bonds
Other
This information will require verification later:
INSURANCE
Confirm You Have These Insurances :
Employers Liability Insurance
Public Liability Insurance
Contract Works Insurance
Current Insurer/s
Current Broker
Next Renewal Date
OTHER INFORMATION
Give any supporting relevant information:
You can email other supporting documents to
quotations@wallace-group.co.uk
Verification of your information will be required later:
Tick the Processing Security Check below:
Telephone 08702405901 for assistance