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Fleet Insurance Full Quote Form

    

Vehicles

Please tell us the vehicles that you would like to include in your Fleet policy.

Accidents/Claims

If there has been any accidents or claims within the last 5 years then please detail them below. (if there hasn't then leave this blank)

Circumstances Date Costs

Convictions

If there has been any Motoring Convictions for any of the drivers that you know will drive and they have happened within the last 5 years, then please detail them below (if there hasn't been any then leave this blank)

Date of Conviction Drivers Full Name Drivers Age No. Years Full Driving Held Conviction Code Fine No. Penalty Points Driving Ban

Your Details

    

Please read the following statements carefully and indicate acceptance below:

  • No proposer, director, partner or family member involved with the business or any other company or business has:
    • in the last ten years been declared bankrupt or insolvent
    • in the last ten years been the subject of a County Court Judgement, an Individual Voluntary Arrangement or a Sheriff Court Decree or
    • in the last ten years been disqualified from being a company director
    • ever had a proposal declined, renewal refused, insurance cancelled by the insurer
    • been convicted of fraud, robbery, theft or handling stolen goods during the past 5 years - unless spent by the Rehabilitation of Offenders Act
  • No proposer, director, partner or family member involved with the business or any person who, to your knowledge will drive under this insurance has:
    • ever had their operators licence revoked or had restrictions imposed
    • in the last three years been prosecuted by the traffic commissioner for, or convicted in connection with any tachograph or drivers hours offence
  • The business:
    • in the last ten years has not been subject to an investigation by HM Revenue and Customs which has resulted in a prosecution
    • has a permanent registered address
    • is not a prison, asylum or detention centre, or a manufacturer, retailer or supplier of arms or munitions, or an unlicensed labour supplier or an animal testing research laboratory
    • does not employ professional sportspersons, entertainers, pop stars or professional models
  • None of the following vehicle types are to be insured under the policy: stretch limousines, emergency response vehicles (including ambulances, colliery vehicles, fire brigade vehicles and mountain rescue vehicles), showman’s vehicles, steam traction engines / steam rollers, land trains, prison vans, amphibious vehicles, breakdown / recovery vehicles, security vans, coaches and buses, advertising vehicles, airport support units, road-testing vehicles, armoured cars/vehicles, home or kit built vehicles, vehicle transporters or Tankers
  • No vehicle to be insured:
    • will be used for motor trade purposes
    • will be used for self drive hire and/or credit hire purposes i.e. any vehicle you hire out or rent to others, without supplying a driver (other than the hiring of Special Type vehicles specified in the policy)
    • will be used for courier/parcel delivery services and where the vehicle is less than 7.5 T GVW
    • will be used for carriage of passengers for hire or reward
    • has any non manufacturer fitted modifications other than vehicles converted to use alternative LPG fuel where the conversion has been carried out by an LPG approved installer
    • will be used for carriage of goods for hire or reward in Northern Ireland
    • is owned or used by any Embassies, High Commissions, or any member of a Royal Family
    • is primarily or regularly used for the carriage of U.S. or Canadian Nationals
    • is registered to or owned by (or hired, leased or lent to) any employee of the policyholder
    • is registered to or owned by (or hired, leased or lent to) any other individual or family member of the policyholder, named director (as per Companies House) or partner within the insured business
  • Unless declared and accepted by the insurer:
    • no vehicle to be insured will carry hazardous substances defined as: any goods carried which are defined (by categories 1 - 9) in accordance with the United Nations (UN) classification requirements. These are in respect of explosives, gases, flammable liquid, flammable solids, oxidising substances, toxic substances, radioactive material, corrosive substances and miscellaneous dangerous goods
    • no vehicle to be insured will visit any hazardous locations defined as: power stations, nuclear installations, refineries or bulk storage or production premises in the oil, gas or chemical industries, Ministry of Defence Premises, Military Bases, Any airport designed for fare paying passengers &/or freight handling, rail trackside or other rail property
    • no vehicle to be insured will be used outside the UK for more than 60 days in any period of insurance
  • No person who, to your knowledge will drive under this insurance has been convicted during the last 5 years of fraud, robbery, theft or handling stolen goods unless spent under the Rehabilitation of Offenders Act
  • Where required by law, a valid Goods Vehicle Operators Licence is held