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Thank you for submitting your quotation, your quotation form has been sent and we will contact you within 24 hours.
Quotation Road Risks
About You (The Proposer)
Full Name*
/>
Age*
Business Address*
Post Code*
Telephone No.*
Daytime
Mobile No*
Preferred Contact Method*
Please Select
About Your Business
Working from
Please Select
Your Status
Please Select
If you work from premises please check this box if you require cover for vehicles at premises
Premises Post Code
(if cover required away from home)
Full Time Motor Trade
Part Time Motor Trade
If Part Time please give other occupation
If Part Time, are you self employed?
Please Select
If Part Time, do you require additional cover for this occupation
Please Select
Number of years established?
Name
Age
Date of Birth
Motor Trade Status
Other Occupation
Use
1
Proposer
Please Select
Please Select
2
Please Select
Please Select
3
Please Select
Please Select
4
Please Select
Please Select
5
Please Select
Please Select
Driver no
Years Licence Held
Accidents/Claims
(last 3 years)
Motoring Convictions
(Last 5 years)
Banned?
Health Conditions
1
2
3
4
5
If you have answered yes to any accidents/claims/convictions/disqualifications or health conditions please give details below:
1
2
3
4
5
6
7
8
9
10
About Your Motor Trade Activities
Are You Involved With?
(Motor trade activities must add up to 100%)
Sales of Vehicles
%
Sales of Parts or Accessories
%
Import and/or Export
%
Mechanical Repairs/Service
%
Tyre Sales/Exhaust Fitting
%
Scrap or Salvage
%
Vehicle Recovery/Breakdown
%
Body Repairs
%
Valeting
%
Other
%
Sports or High Performance
%
Classic
%
Motorcycles
%
Coaches or Buses
%
Modified or Kit Cars
%
Commercial Vehicles over 3.5t
%
American or Canadian
%
Japanese Imports
%
Vehicles with more than 8 seats
%
Other
%
Cover
Type of Cover Required
Please Select
Voluntary Excess
Please Select
Maximum Value any one vehicles
Please Select
Total Value of all vehicles
Please Select
Would you like to include accompanied Demonstration Cover?
Please Select
No Claims Bonus
Are you entitled to any No Claims Bonus?
Yes
NO
If Yes, please advise which type of No Claims Bonus
Please Select
Number of Years earned
Please Select
When does your current policy expire?
Motor Trade Insurance Specialists
Authorised and Regulated by the Financial Services Authority (FSA) Registration Number 304327
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