Minibus Quotation
Wise Insurance Services Limited
168 Croydon Road
Beckenham
Kent
BR3 4DE

020 8663 3939

PROPOSER DETAILS

Title:
Name:
Address:
Post Code:
Date of birth:
Telephone:
Email:
Occupation:
Where kept overnight:
Use of minibus:
Details if other:
No years no claims:
Type of bonus earned:
Details if other:
Is there a NCD available to use on minibus:
Reason for having a minibus:
Date Licence Obtained:
Disabilities:

VEHICLE AND INSURANCE DETAILS

Make of Vehicle:
Exact Model:
Number of seats:
Year of make:
Vehicle value:
Security fitted:
Cover Required:
Driving restrictions:

ADDITIONAL DRIVERS

Driver 2
Name:
Date of birth:
Date Licence Obtained:
Disabilities:
Driver 3
Driver 4

CLAIMS OR LOSSES IN PAST 5 YEARS

  Claim 1
Driver No:
Claim date:
Fault / Non-Fault:
Cost:
Lost no claims bonus:
Claim 2
Claim 3

MOTORING OFFENCES

  Offence 1
Driver No:
Date:
Conv. Code
Points:
Fine:
Suspension:
Offence 2
Offence 3