LABC Latent Gold Proposal Form

Name of Proposer:                     Contact Name:       

Address 1:                                 Address 2:              

County:                                      Postcode:               

Email Address:                           Telephone Number:

Location of Premises to be insured:                                     

Name of Owner (if not Proposer):                                        

Interest of Owner in the Premises (if not Proposer):           

Name and address of architect:                                           

Is the construction contract signed under seal?                   Yes No

Name and address of Main Contractor:                                

Does the Owner/Proposer intend to retain or sell
on their interest in the Premises?                                        

Name and address of the Local Authority Building
Control (LABC) inspector providing inspection services: