MINDER POLICY QUOTE FORM

Transcription

1 MINDER POLICY QUOTE FORM Intended for full time MOTOR TRADERS who are involved with customers vehicles in servicing, repairs or movement /fax to or to Please answer ALL questions. Broker s name Telephone number address Contact name Fax number Quote required by Target Premium PROPOSER S DETAILS Name of proposer Trading name address Mobile telephone Business address The quote is recorded against the name, postcode and telephone details Motor Trade Business Explain the proposer s activity in full Where does the proposer work from: Home q & mobile Home with q workshop Workshop q Premises q shared with others Open yard q /forecourt Other q (Please specify) Capacity of vehicles Type of premises How long at these premises years Vehicles contained: Within a locked building % Within a locked yard % In open on road % Type of tenure and building: Owner q Leaseholder q Monthly tenancy q Sharing with q others Subletting from q another INSURANCE REQUIREMENTS/HISTORY How many vehicles are handled per year Turnover Is proposer VAT registered Cover required Standard Excess Voluntary Excess Voluntary Excess Voluntary Excess COMP q 500 Standard q ADF&T 1,000 q ADF&T 1,500 q ADF&T 2,500 q ADF&T TPF&T q 500 Standard q F&T 1,000 q F&T 1,500 q F&T 2,500 q F&T TPO q NIL q 250 q TP Property 500 q TP Property damage damage Note: Good discounts available for higher excesses. Present insurers name Expires Number of years bonus yrs Motor trade q Private car q CV q Motorcycle q If no NCB then we require details of how experience obtained. A discount may be available for the best story! (Show in Additional information box overleaf ) Tradex Insurance Company Limited Victory House, 7 Selsdon Way, London E14 9GL T: I Tradex Insurance Company Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Register number Registered office: Victory House, 7 Selsdon Way, London E14 9GL. Registered in England and Wales No /0145W

2 VEHICLES TO BE DRIVEN/ROAD RISK EXTENSIONS Vehicles up to group ABI code 28 are included automatically Commercial vehicles are allowed up to 3.5 tons GVW Do they require unlimited grouping Do they require a higher limit cwts/gvw required Do they require breakdown risks/towing cover Are they contracted to any national recovery company Motorcycles: cc limit Limit of indemnity: Any one vehicle - Own vehicle Max value Do they specialise in motorcycle repairs? 5,000 q 10,000 q 15,000 q 20,000 q 25,000 q Any one vehicle - Customer s vehicle 25,000 q 37,500 q 50,000 q 75,000 q 100,000 q Other q Customer loan vehicles? How many? COMP q TPO q DRIVERS Named drivers Age Usage MT / SD&P / OB* (Delete inappropriate) State if principal Partner/ Employee/ Friend or Family 1 Proposer MT / DS&P / OB P / E / F 2 MT / DS&P / OB P / E / F 3 MT / DS&P / OB P / E / F 4 MT / DS&P / OB P / E / F 5 MT / DS&P / OB P / E / F Use additional sheet if necessary *OB = Other Business Full licence years Has any driver in the last five years; Been convicted of ANY motoring offence (other than parking), sustained a fixed penalty which has resulted in the driving licence being endorsed or have a prosecution or enquiry pending? Received ANY police cautions, antisocial behaviour orders, been convicted of or charged with but not yet tried for ANY nonmotor offences or are any police enquiries pending whether in the United Kingdom or elsewhere? Had any claims/accidents? In the last 10 years has any partner or director of the business or driver to be insured; Had county court judgments issued against them in England and Wales and/or orders or judgments for debt in other jurisdictions, set up an Individual Voluntary Arrangement (IVA), been disqualified from acting as a company director for any period of time or been declared bankrupt or insolvent? Been a director of a company that has gone into liquidation, receivership, been the subject of an administration order, or which has been dissolved? Does any driver have disabilities that require disclosure to the DVLA, DVA or holds a restricted licence? Has any driver: Been refused insurance or renewal of a policy? Had a policy cancelled due to non payment of premium or for any other reason? Had a policy avoided? Been asked to agree special terms or premium? If YES to any of these questions please give full details below Had a claim repudiated or refused? page 2

3 OTHER BUSINESS USE Name Describe main occupation(s) and usage Miles per week Area of use Vehicle(s) used 1 Proposer PERMANENTLY OWNED VEHICLES (DETAIL ALL VEHICLES) Despite the fact that this is a Motor Trade policy the proposer is required by law (EU Directives) to disclose all vehicles that they own or drive. The only exceptions are customer s vehicles or stock vehicles that are held for resale and are driven under a trade plate. Social, domestic and pleasure use is excluded from vehicles that have NOT been disclosed below. Registration No Make Model Date purchased CC GVW Year Purchase price Main Driver where kept Annual mileage PREMISES COVER - OPTIONAL EXTENSION Trade premises cover Address Give address details Give details of Construction of Premises/Age and other occupants and their trades, if shared Give brief details of physical protections and alarms, if applicable Intruder Alarm NSI If YES installer s name Annunciation: Bell q Digital q To central Station/Redcare q Are any vehicles parked on the road outside the trade premises at night If YES, give details of how they are secured against theft or vandalism Have there been any claims or losses in the last 5 years whether insured or not? If yes give full details overleaf If these are new premises occupied by the proposer, are they aware of any losses or damage sustained by the previous occupant? Are the trade premises in a good state of repair and regularly maintained? Is the property heated by unfixed or mobile appliances? If YES, give details page 3

4 CONTINUED Are any of the following undertaken at the premises Welding Cutting Spraying Is waste removed from the premises daily q weekly q other q give details Sums insured Applies to each location Total value of own vehicles Total value of customer s vehicles Total value of vehicles at subcontractors premises Buildings/tenant s improvements and decorations Fixed plant and equipment Stock (ex radios/tobacco/video/wine & spirits) Stock specify: Portable tools (1,000 any one item unless specified) Employees tools (1,000 any one item unless specified) Portacabins Property in portacabins Machinery in open Fuel oil Total Consequential loss Turnover Indemnity Limit 12 months Do they require cover for loss of MOT Licence Percentage of turnover from MOTs % Do they require cover for Rent Payable? Rent payable Liabilities Annual T/O (ex VAT) PA Annual wages paid to manual employees PA Self employed labour/casual labour (wages) PA Principal/Directors/Partners drawings and salaries PA All other non manual employees (wages) PA Total Indemnity required - tick box(es) Public Liability Indemnity 1m q 2m q 5m q Service/Defective Workmanship/Sales Indemnity 1m q 2m q Employer s Liability* 10,000,000 q Working partners *ERN Number will be required Money Limit any one carrying Safe limit - out of hours Out of hours out of safe (ie petty cash) Glass On external glass On signs/canopies On internal mirrors and sanitary ware GOOD/VEHICLES IN TRANSIT The road risks policy does not provide cover for motor vehicles/caravans/trailers/equipment whilst being conveyed on breakdown trucks, transporters or trailers or whilst being towed, other than for TP only. Is wider cover required Customer Vehicles maximum value on any one vehicle Towed Caravans/Trailers maximum value on any one caravan/trailer Construction Plant/farming equipment or similar maximum value of equipment Stock and Parts in transit Portable Tools and equipment NOT permanently fixed to the vehicle Plant/Equipment /Lifting Gear fixed to the vehicle Give details of individual equipment to be insured if value is over 1,000 page 4

5 ADDITIONAL INFORMATION Vehicle security Are all transporting vehicles fitted with Alarms q Immobilisers q Trackers q Additional physical security q Please specify Overnight security Are vehicles left loaded overnight Are they always contained within a locked building, secured yard or manned lorry park If NO, give details of the security ADDITIONAL INFORMATION Please pro vide any information that you think is essential to the risk or reduces our exposure and should be given consideration in our rating Completed by I have known the proposer Years Broker New customer q page 5