Motor Trade Quote Form

Please complete the Quote Form below

Any Queries call 01989 565613

Your information
Title
First name
Surname
Date of Birth  
Building number or name
Postcode
Telephone
Email address
The cover you require
Cover start date?
Cover Required
Level of Indemnity
Proposer Age
Other drivers Age     If Director, Enter Postcode
  
  
  
  
Part time motor trader?   Other Occupation 
Nature of your work  
How long has your business been established?
No claims discount (motor trade)
With which company ?
No claims discount (private car)
Demo use required?
Premises cover required?    
Do you deal with : Motorcycles:    American:    Canadian:   
Classic Vehicles:    Modified vehicles:   
What's the Post Code of your business?
What's the best quote you've had so far in £?
Where is that quote from?
Has the proposer/director, or any additional driver, ever
Has the Proposer suffered a loss, claim or incident (which may give rise to a claim) on own policy, or any other individuals policy, in the last 5 years?    
Been convicted of, prosecuted for or are any prosecutions pending for any criminal offence (other than motoring convictions)?    
Been convicted of any motoring conviction endorsable on driving licence in the last 5 years?    
Not been resident in the UK for the past 3 years or held a full UK driving licence for the past year?    
Suffered any medical conditions that affect their driving which had not been notified to the DVLA?    
If YES to any of the above, please give full information
Do you deal with any sports / high performance or any imported vehicles?

If YES, please give full information
I confirm the information I have provided is true and accurate and I understand if any details are false or inaccurate this may affect my insurance policy. This could be, additional terms imposed, claims may be repudiated or in serious cases treated as null and void.
Other Optional Information
Where did you hear about us?
What is the best time to contact you?
Any other comments or information that will help us?
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