Motor Fleet Insurance

    Pesonal Information

    For What Date is the Insurance Required

    Title

    First Name

    Surname

    Business (Company) Name/Trading Name

    Business Address

    Email Address

    Daytime Telephone No.

    Mobile Telephon No.

    What is the Legal Status of Business?

    Is there a secondary trade or Occupation

    Please Note: There is no need to specify a second trade unless work is undertaken that is distinct or separate the main trade and you need it to be covered by this policy

    When was the business established?

    How long have you held a responsible position working in this trade

    Losses

     

     

     

    Have you had any losses or incidents that have or could have given rise to claims in the last 3 years

     

     

     

     

    Details

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