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Motor Trade Quote Form

Please complete the Quote Form below

Any Queries call 01989 565613

Your information Business partner
Title Title
First name First name
Surname Surname
Date of Birth   Date of Birth  
Email address Email address
Home, Premises and Business Partner Address
Trading from :    
Address : Home Premises Business partner
Building no. or name
Type of Dwelling
Business information:
Date Business Established:       
Trading Name:
Estimated Annual Turnover:    
Estimated Annual number of vehicles dealt with in 1 year:    
Target Price:    
Renewal Date or Expiry Date of last policy:       
Motor Trade:
Motor Trade Occupation:      
No Claims Bonus: From Motor Trade    
  Commercial Vehicle    
  Other: Please advise type of policy:
Indemnity limit (max value per vehicle) £    
Split indemnity required: Own vehicles: £    
  Customer vehicles: £    
Accompanied Demonstration Required?
(Only available for vehicle sales)
Motor Trade Activity
Purchase & Resale % Mechanical/Servicing % Body Repairs % Accessory fitter %
Tyre Fitter % Vehicle Recovery % Collection & Delivery of vehicles for third parties for a fee %
Please specify max GVW Other % Please specify    
Total %            
Are you involved in any car breaking or repossession of vehicles?        
Do you deal with vehicle in excess of 3.5 ton Please specify max GVW
Do you deal with vehicle over 7 passenger seats?        
Class of Vehicles
Sports % Kit % Q Plated % American/Canadian % Modified % Japanese Imports % Standard cars %
Motorcycles % How long have you held full UK motorcycle licence? What’s the maximum cc limit?    
Other % Please specify              
Total %                  
All drivers lived in the UK for 5 years or more and held full uk driving licence for at least 3 years? 
If not, please provide full details below
Name Date of Birth Full or Part Time Other Occupation Driver Status Years UK Licence Held Usage MT / SDP
Additional Business use for any other occupation required? 
If so please state driver and business type:
Personal Vehicles
Make Model Year Value Registration Number
Sale Vehicles
Make Model Year Value Registration Number
Accidents / Claims
Driver Date Accident/Fire/Theft/Other Costs Circumstances
Motoring Convictions
Driver Date Conviction Code Fine Points Length of Ban
Any non-motoring convictions: Please give full details including dates and outcome:
Have any of the named drivers
Suffered any medical conditions that affect their driving which had not been notified to the DVLA?   
Ever had insurance refused/cancelled or had terms imposed?   
Ever been bankrupt or have any CCJ’s?   
if so, please enter details in the box below:
Other Information
Where did you hear about us:
Do you require any additional cover if so please provide full details in the comments box below:
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.   
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