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Cleaning Industry - Declaration Form

Policy Number
Insured Name
Period From
Period To
Principals WagesOwn Employees Wages (Including labour only sub contractors)Payments To Bona - Fide SubcontractorsTurnover
1) Clerical Work
2) Window Cleaning At Ground Level
3) Window Cleaning By Pole System
4) Window Cleaning Below 10M
5) Window Cleaning Above 10M
6) Abseiling / Rope Access Work
7) Domestic, Shop & Office Cleaning (Inc Carpet Cleaning)
8) Supermarkets & Shopping Centres
9) Factory, Kitchen, Industrial Cleaning
10) Specialist Machinery Cleaning
11) Pressure Washing / Jetting
12) Any Other Work (Please Give Details
Totals
Total No Of Employees
Email Address - *
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