Quote4Insurance

Motor Trade Insurance Request

Combined Quotation

Section 1 - Personal Details

 

 
Full Trading Name
Title
First Name
Surname
Contact Telephone Number
Email
Business Address
Town
City
County
Post Code
Cover Required
Best Time to Call
   
Section 1 - Address for Correspondence ( If different from above )
   
Address
Town
City
County
Post Code
Contact Telephone Number
Email

 

Section 2 - Nature of Business

 

 
Sales
Service
Valeting
Delivery Agent
Mechanical Repairs
Body Repairs
Import / Export
Recovery
Other
Involved in Scrap / Salvage or Recovery
How many years in motor trade
When was business established
   

 

Section 3 - Do you specialise in Selling, service or Restoring

 

 
Sports, high performance, high value, (over 20k) or modifying vehicles?
Veteran / Vintage / Classic Cars ?
Agricultural vehicles or Contractor's Plat ? 
Buses or Coaches ?
Vehicles of 3.5 tons G.V.W. or more ?
Manufacture or Remanufacture of tyres,  vehicle parts of accessories ?
Currently have a Motorcycle over 500cc ?
If Paint Spraying, is there a spray booth ?
If Involved in the same and refitting of tyres, are they new ?
Modified Vehicles
Motorcycles
Vehicles other than standard saloons or light goods
   
Details of vehicles owned but not for sale
 
 
   
Details of vehicles for sale
 
 
 

 

Section 4 - What Road Risks Indemnity Limit Is Required

 

 
Indemnity Limit
   

 

Section 5 - Details of Principal / Partners / Directors / Employees
               
Name D.O.B Age Status Licence Held UK Resident Bus SDP

 

Section 6 - Accident Details
         
Claims in  Motor Convictions  Banned

Criminal Convictions

Physical Disabilities

Last 3 yrs in last 5 Years  
 

 

Section 7 - No Claims Bonus

 

 
If No, give reasons
If Yes, how many years and what percentage
   
In respect of the cover now proposed, has client or any Director or Partner sustained any loss or damage during the last five years which has or could have resulted in a claim?
 
If Yes, give details
Have you had insurance declined /cancelled or had special terms applied.
If Yes, give details
Have you ever been declared bankrupt or insolvent
   
How did you hear of Quote4insurance?
e.g. Name of magazine/newspaper you saw our advert in, T.V., radio, Teletext,diverted from other site = please name site / search engine, internet advert etc.