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Motor Trade Quotation
To help us provide you with out best possible quotation, please complete as much of the following quotation form as you can.
 
Title
Name
Trading Name
Address
Address 2
Address 3
Address 4
Postcode
Telephone
Email
Full Time Occupation
Part Time Occupation
Years Trading
Trading From
   
Road Risks Cover
Details of all persons who will drive including yourself:
eg. NAME - AGE - YRS FULL LICENCE - PROPRIETOR / SPOUSE / EMPLOYEE
Has Anyone Who May Drive:-  
Been convicted of any driving offence in the last five years
Been disqualified in the last 10 years
eg.
NAME - CONVICTION CODE - CONV DATE - POINTS - DISQUALIFIED Y/N - LENGTH OF BAN
Any disease, disability or infirmity
eg.
NAME - DISEASE - DISABILITY - INFIRMITY
Been involved in any motor claim in the last three years
eg. NAME - ACCIDENT/LOSS DATE - FAULT/NON FAULT ACCIDENT OF THEFT - AMOUNT CLAIMED
Have you or and one disclosed ever been convicted of, or charged (but not yet tried) with a criminal offence
eg. NAME - DETAILS OF CONVICTION

List all vehicles owned and used by you for your personal or business use.
  
eg. VEHICLE MAKE & MODEL - YEAR - VALUE
Do you operate a recovery vehicle
If yes then enter details eg. RECOVERY VEHICLE MAKE & MODEL - YEAR - VALUE
   
Do you specialise in the following:
Prestige, Sports or high performance vehicles
Veteran, Vintage or Classic Vehicles
Commercial Vehicles over 3.5 tonnes
Public Service Vehicles
Motorcycles
Cover required
Indemnity Level required (Max vehicle value)
How many years No-Claims-Bonus
Additional Covers - Stock of vehicles required
Number of vehicles
Single vehicle value
Total vehicle value
Internal or Garage Risks Required
Buildings
Fixed Plan & Machinery
Portable Tools
Stock
Business Interruption Required
Gross Proffits
Goods in Transit Required
Sums Insured
To include vehice transport
Money Required
Wrongful Conversion Required
Sums insured (min £5,000)
Public Liability Required
Employers Liability Required
Defective Workmanship / Sales Indemnity Required
   
In order to calculate the premiums for the liability sections we require the following information:
Projected approximate annual turnover
Projected approximate annual wages roll
Have you made a claim in respect of the above in the last 3 years
Ever been declared bankrupt or insolvent?
Been convicted of any criminal offence, which is not 'Spent'?
Had any County Court Judgements entered in the last six years?
   
 
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WestPennine Insurance Services Group is the trading name of WestPennine Insurance Consultants Limited. Registered Office 84 Church Street, Littleborough. OL15 8AU. Registered in England number 939318
Telephone 01706 378990 Fax 01706 371417
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