Road Runner Motor Trade Insurance UK
 
  Broker
  Contact     Tel
  Agent Name     Fax
  Postcode     E-mail

  The Proposer     The Business
  Full Name
  Trading Name
  Business Addr.
  Postcode
  Tel
 
  Type
  Annual Turnover £
  Year Established

  Trading From     Cover Required
  Home %
  Premises %
  Mobile %
 
  Public Liability
  Service Indemnity
  Products Liability
  Employers (£10m) Yes    No
  Limit of PL (£m) 1      2      5

  Previous Insurance Details
  Insurer     Previous Liability
  Claims
  Expiry Date  
  Policy No  

  Motor Trade Activities     Is The Business Involved With
  New Vehicle Sales %
  Used Vehicle Sales %
  Mechanical / Servicing %
  Crash / Body Repairs %
  Accessory Fitting - New %
  Accessory Fitting - Used %
  Towbar Fitting %
  Tyre Sales / Fitting %
  Breakdown Recovery %
  Vehicle Valeting %
  Other: %
 
  Cars & Light Commercials %
  CVs over 3.5T %
  Vintage / Classic Vehicles %
  Motorcycles %
  Sports / Performance %
  Modified / Kit Cars %
  Minibuses / Coaches %
  Agricultural / Plant %
  Motorised Horseboxes %
  Trailers / Caravans %
  Rally / Track / Race %
  Other: %

  The Proprietors / Directors / Employees
  No Full Name Date of Birth Motor Trade Status
  1 Proprietor / Director
  2
  3
  4
  5
  6

  No Manual / Clerical Family Member? Cover Required Annual Wage / Drawings
  1 N/A £
  2 £
  3 £
  4 £
  5 £
  6 £

  Does Work Involve?     % Of Turnover From Heat Work
  Soldering Irons Yes    No
  Blow lamps, hot air guns Yes    No
  Welding / Cutting Premises Yes    No
 
  On the premises %
  Away from the Premises %

  Material Facts
  Additional information that you feel may be relevant.




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Road Runner Motor Trade Insurance is issued by Road Runner Motor Trade Ltd, which is authorised and regulated by the Financial Services Authority (Reg No. 304410).
For your protection, telephone calls may be recorded or monitored.
Copyright © Road Runner Motor Trade Ltd 2008