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Include information relative to any other loss or damage not covered by questions 1 2 or 3 of this form. Policyholder s Signature Date Allianz 3 Cromac Quay The Gasworks Ormeau Road Belfast BT7 2JD Tel 028 9089 5600 Fax 028 9043 4222 E-mail info allianz-ni. Transit Claim Form 1 Insured Name of Policyholder Address Postcode Policy No* BT CGL Phone No* Home Business Email Do you use conditions of trading If Yes What are they Work Yes Are they applicable in this case If No do you accept common...

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