MINIBUS INSURANCE
Hire & Reward
Quotations

  Minibus Quotation
( Saving Pounds )
FROM:

 

Your name
Your contact telephone / mobile ( Mobile if Possible Please )
Your E-Mail address

 
Proposer Details
Your First Name
Your Last Name 
1'st line Home address
2'nd line Home address
Town / City
UK County
Full Post Code
Years lived in UK
Homeowner Yes/No

Married Yes/No

Date of Birth

Type of Use ( eg Social or Hire and Reward )

Cover Required

Please give the month cover required from.

Taxi Base Post Code
(if Applicable )

   e.g. BB12
 

Vehicle Details
Vehicle Make, ie, Ford
Model, ie,  Transit Minibus
Model, ie ,LX 
Engine Size,cc

Petrol or Diesel

Vehicle Value

How many Seats including driver in total

Year of Manufacture

Modified - Yes/No?

 Yes or No
 
Details of All Drivers

  list all drivers inclusive of yourself
Name

Date
Of
Birth

Yrs UK driving licence

Yrs Taxi Licence

Occupation if not Taxi driver

 Annual
Mileage
1       policyholder
2
3
4  Any Disabilities ?

Has any driver, had any Convictions ?:  in the last 5 years or ban in last 10 yrs

 Yes or No          If Yes, please give details below:
 

Name

conviction code

conviction date

penalty points 

date ban expired

fine imposed
1

2

3

4

5

Has any driver had any Accidents?: in the last 5 yrs

 Yes or No        If Yes, please give details below:
 

Name

Date of accident

Fully
Settled Yet?

Total costs you claimed

Total costs  claimed against you

Fault or None Fault
1
2
3
4
5

How many years No Claims Bonus
can you provide.

 Was your bonus earned on
a ''Taxi'' Minibus Policy / Normal Minibus Policy / or Private Car Policy

ALL QUOTES PRODUCED ARE INDICATIVE ONLY


PLEASE KEEP A COPY OF THIS DOCUMENT SAFE FOR  REFERENCE.