<% 'Specify your captcha length here, this is the only configuration requirement captchaLength = 5 Function captcha(captchaLength) if captchaLength > 15 then captchaLength = 15 HighestValue = left(100000000000000,captchaLength) lowestValue = left(999999999999999,captchaLength) Randomize intHighestNumber = Int((HighestValue - LowestValue + 1) * Rnd) + LowestValue session("captcha") = Int(intHighestNumber) x = 1 response.write vbcrlf & "
" & vbcrlf & vbtab & "" & vbcrlf while x <= captchaLength response.write vbtab & vbtab & "" & vbcrlf x = x + 1 wend response.write vbtab & "" & vbcrlf & "
" & vbcrlf End Function if trim(Request.Form("email")) <> "" then if cstr(request.form("captcha")) = cstr(session("captcha")) then Dim oMail Set oMail = server.CreateObject("cdo.message") oMail.From = "info@topmarques.uk.com" 'oMail.ContentType = "text/html;" oMail.To = "info@topmarques.uk.com" oMail.Subject = "Quotation Questions from TopMarques website" sStr = "
Correspondence Details


Name: " & Request.Form("fname") sStr = sStr & "

Postcode: " & Request.Form("Postcode") sStr = sStr & "

Telephone: " & Request.Form("Telephone") sStr = sStr & "

Email: " & Request.Form("email") sStr = sStr & "

Business Details

Name: " & Request.Form("BDname") sStr = sStr & "

Postcode: " & Request.Form("BDpcode") sStr = sStr & "

Trade / Business : " & Request.Form("BDtrade") sStr = sStr & "

Years trading: " & Request.Form("byearTrade") sStr = sStr & "

Years experience: " & Request.Form("bYearsExp") sStr = sStr & "

Contents section

Tenants Improvements Sum Insured: " & Request.Form("TImpSumIns") sStr = sStr & "

Computers (not stock) Sum Insured: " & Request.Form("compsumInsured") sStr = sStr & "

Other Electronic Equipment Sum Insured: " & Request.Form("OElectEqpSumnsured") sStr = sStr & "

Documents Sum Insured: " & Request.Form("DocumentsumInsured") sStr = sStr & "

Shop Front Sum Insured: " & Request.Form("shopFrntsumInsured") sStr = sStr & "

Fixtures & Fittings Sum Insured: " & Request.Form("fixFittSumInsured") sStr = sStr & "

Wines & Spirits Sum Insured: " & Request.Form("WinesSpiritSumInsured") sStr = sStr & "

Cigarettes & Tobacco Sum Insured: " & Request.Form("CigrattesTobaccoInsured") sStr = sStr & "

Attractive Stock (jewellery, etc) Sum Insured: " & Request.Form("AttractiveStockInsured") sStr = sStr & "

Other Stock in Trade & Goods In Trust Sum Insured: " & Request.Form("OtherStockInsured") sStr = sStr & "

Additional cover

Is Money cover required? " & Request.Form("SelMoneycoverReq") & "-£" & Request.Form("inSelMoneycoverReq") sStr = sStr & "

Are the premises protected by a NACOSS approved ALARM? " & Request.Form("selPreProtec") sStr = sStr & "

Is your alarm connected to a central station " & Request.Form("SelalarmConnserv") sStr = sStr & "

Does the alarm have REDCARE " & Request.Form("SelAlarmHaveRed") sStr = sStr & "

Is Buildings cover required? " & Request.Form("selBuildingcovReq")& " - £ " &Request.Form("inputBuildingcovReq") sStr = sStr & "

The standard cover is Fire and Perils, do you wish to extend cover to include Accidental Damage? " & Request.Form("selStndrdCover") sStr = sStr & "

What year was the property built? " & Request.Form("inputProptybuilt") sStr = sStr & "

Is the property of standard construction? " & Request.Form("selProptystndrConstruction") sStr = sStr & "

Is there any flat roof " & Request.Form("SelFlatroof")& "-" & Request.Form("inputFlatroof") sStr = sStr & "

Is Business Interruption required? " & Request.Form("SelbusiInterrreq")& " - £" &Request.Form("InputbusiInterrreq") sStr = sStr & "

Is Outstanding Debit Balances cover required? " & Request.Form("SelOutsDbtBalancesReq")&" - £ " &Request.Form("inputOutsDbtBalancesReq") sStr = sStr & "

Public Liability level of indemnity required " & Request.Form("selpublicLiability") sStr = sStr & "

Is there any work away from premises " & Request.Form("selIsanyworkawayfromPremises") sStr = sStr & "

Additional details

Have you or any director or partner incurred any loss, destruction, or damage or made any claim or had any claim made against you in the last 5 years? " & Request.Form("selPartnerincurredLoss") sStr = sStr & "

Does any other business occupy or operate from these buildings? " & Request.Form("selDoesbussiOcupyfrmBuild") sStr = sStr & "

Are any External Doors NOT secured by 5 lever mortice deadlocks conforming to BS3621? " & Request.Form("selExDoornotScrd") sStr = sStr & "

Are any Accessible Windows NOT secured by key operated windows locks? " & Request.Form("SelAnyWindownotscrd") sStr = sStr & "

Final details

Have you been convicted of, or in the course of being charged with, any offence (excluding driving offences) " & Request.Form("selconvicted") sStr = sStr & "

Have you been declared bankrupt or been a director of any company that went into liquidation " & Request.Form("SelDeclrdBakrupt") sStr = sStr & "

Have you had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed " & Request.Form("SelHavehadInsurance") sStr = sStr & "

Please add any additional information that may be required for your quotation in the space below " & Request.Form("textAddtnlDtl")& "

Kind Regards,

" & Request.Form("fname") 'document.write(Request.Form("method")) if Request.Form("method") <> "" then sStr = sStr & "

Preferred Method?: " & Request.Form("method") end if 'sStr = sStr & "

Query: " & Replace(Replace(Request.Form("query"),chr(13),"
"),chr(10),"
") oMail.HTMLBody = sStr 'Response.Write(sStr) oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/sendusing")=2 'Name or IP of remote SMTP server oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpserver") _ ="localhost" 'Server port oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpserverport") _ =25 oMail.Configuration.Fields.Update Response.Write("") 'Response.Write(sStr) oMail.Send else sErrMsg = "Please enter correct numbers from the image below" end if end if %>
Call 01543 37 37 00
<% if sErrMsg <> "" then %>
<% end if%>
Home > Quote Now

Quote Now

Quotation Questions

Correspondence Details

First Name*

" name="fname" type="text" class="input" />

Postcode

" name="Postcode" class="input" />

Telephone

" name="Telephone" class="input" />

Email*

" name="email" type="text" class="input" />

Business Details

First Name

" name="BDname" type="text" class="input" />

Postcode

" type="text" class="input" />

Trade/Business

" type="text" class="input" />

Years trading

" type="text" class="input" />

Years experience

" type="text" class="input" />

Contents Section

Tenants Improvements Sum Insured

" type="text" value="0" class="input" />

Computers (not stock) Sum Insured

" type="text" value="0" class="input" />

Other Electronic Equipment Sum Insured

" type="text" value="0" class="input" />

Documents Sum Insured

" type="text" value="0" class="input" />

Shop Front Sum Insured

" type="text" value="0" class="input" />

Fixtures & Fittings Sum Insured

" type="text" value="0" class="input" />

Wines & Spirits Sum Insured

" type="text" value="0" class="input" />

Cigarettes & Tobacco Sum Insured

" type="text" value="0" class="input" />

Attractive Stock (jewellery, etc) Sum Insured

" type="text" value="0" class="input" />

Other Stock in Trade & Goods In Trust Sum Insured

" type="text" value="0" class="input" />

Additional cover

Is Money cover required?

" type="text" />

Are the premises protected by a NACOSS approved ALARM?

Is your alarm connected to a central station

Does the alarm have REDCARE

Is Buildings cover required?

What year was the property built?

" />

Is the property of standard construction?

Is there any flat roof

Is Business Interruption required?

" type="text" />

Is Outstanding Debit Balances cover
required?

" type="text" />

Public Liability level of indemnity required

Is there any work away from premises?

The standard cover is Fire and Perils,
do you wish to extend cover to include Accidental Damage?

Additional details

Have you or any director or partner
incurred any loss, destruction, or damage
or made any claim or had any claim made against you in the last 5 years?

Does any other business occupy or operate from these buildings?

Are any External Doors NOT secured by 5
lever mortice deadlocks conforming to BS3621?

Are any Accessible Windows NOT secured by key operated windows locks?

Final details

Have you been convicted of, or in the
course of being charged with, any offence (excluding driving offences)

Have you been declared bankrupt or been a director of any company that went into liquidation

Have you had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed

Please add any additional information that may be required for your quotation in the space below

<%captcha(captchaLength)%>

 

Request a call

I agree with the terms & conditions

Submit

© Copyright , All Rights Reserved, Top Marques Insurance
Top Marques Insurance trading style of Sportauto Limited
Registered in England and Wales No: 2993405

Site Developed by: Five Rivers | IT Support | Internet Marketing