KiddieBus | Minibus | Insurance Quote Request | Morton Michel

KIDDIEBUS QUOTATION SHEET

Please complete the information below as full as possible. Questions marked with a * are manadatory

Renewal / Inception Date   *   Please enter renewal date Date format must be 'dd/mm/yyyy'.
Best Quote you’ve had   *   Please enter a value or N/A if you do not have a 'Best Quote' yet.
Current Insurer:   *   A value is required.

Driver No. 1 Details

Full Individual or organisation Name *
A value is required.
Marital Status *
Sex *

Address Line 1 *
A value is required.

Address Line 2

City * A value is required.
County * A value is required.
PostCode * A value is required.
Contact Telephone Number * A value is required.

E-mail Address * A value is required.
Licence: *
Years licence held: * A value is required.
Date Passed: * Date format must be 'dd/mm/yyyy'.
UK Born: *
Where were you born?
Please state date you moved to the UK Date format must be 'dd/mm/yyyy'.

Convictions

Offence Code: *
Offence Date: * Date format must be 'dd/mm/yyyy'.
Points: *
Fine: *
Banned: *

Accidents / Claims

Claim Date: * A value is required. Date format must be 'dd/mm/yyyy'.
Claim Cost: * A value is required.
Your Fault: *
Injury: *
Circumstances: *

A value is required.

How would you like us to contact you: *

Telephone
E-mail
Post

Date of Birth (unless quote in company name) A value is required. Date format must be 'dd/mm/yyyy'.
Occupation: * A value is required.
Type of Business: * A value is required.
Medical Condition: * A value is required.
Are DVLA Aware? *

VEHICLE DETAILS

Vehicle 2

Make

Full Model

Registration Number

Standard Right Hand Drive
Transmission
Fuel Type
Purchase Date

Engine Size

Date of Manufacture

Number of Doors

Number of Seats

Market Value

Type of Cover required
Years of No Claims Bonus
Protect No Claims Bonus?
Who is the main driver?

Vehicle 1

Make *
A value is required.
Full Model *
A value is required.
Registration Number *
A value is required.
Standard Right Hand Drive*
Transmission *
Fuel Type *
Purchase Date *
Please enter Purchase date (dd/mm/yyyy)
Engine Size *
A value is required.
Year of Manufacture *
Please enter the year of manufacture Invalid Year EnteredInvalid Year EnteredInvalid Year EnteredInvalid Year EnteredInvalid Year Entered
Number of Doors *
A value is required.
Number of Seats *
A value is required.
Market Value *
A value is required.
Type of Cover required *
Years of No Claims Bonus *
Protect No Claims Bonus? *
Who is the main driver? *
A value is required.

Modifications

A value is required. Overnight Parking * (Please select most appropriate)
Owner and Registered Keeper *
A value is required.
Postcode where vehicle kept overnight (if different to above)
Total Annual mileage * A value is required.
Business mileage * A value is required.

Vehicle Usage * (please select one of the following)

Vehicle Restrictions *

ADDITIONAL DRIVERS

Driver 3

Title
Forename
Surname
Sex
Date of Birth
Marital Status
Type of Licence
Years licence held A value is required.
Date Passed
UK Born
If No,
where were you born?
Date moved to UK
Any medical conditions
DVLA Aware
Occupation and Business
Relationship to Proposer

Convictions

Offence Code:
Offence Date:
Points:
Fine:
Banned:

Accidents / Claims

Claim Date:
Claim Cost:
Your Fault:
Injury:
Circumstances

Driver 2

Convictions

Offence Code:
Offence Date:
Points:
Fine:
Banned:

Accidents / Claims

Claim Date:
Claim Cost:
Your Fault:
Injury:
Circumstances

Driver 5

Convictions

Offence Code:
Offence Date:
Points:
Fine:
Banned:

Accidents / Claims

Claim Date:
Claim Cost:
Your Fault:
Injury:
Circumstances

Driver 4

Convictions

Offence Code:
Offence Date:
Points:
Fine:
Banned:

Accidents / Claims

Claim Date:
Claim Cost:
Your Fault:
Injury:
Circumstances

Optional Extras: (Tick if required)

Breakdown cover?
Gauranteed Replacement Vehicle
Legal Expenses
Keycare Cover

Would you also like us to contact you for a household quote?

Additional Information

Please note we will get back to you within 1 working day of receiving your details