0800 917 5227
Motor Trader Insurance
e.g. Ford Focus
Email
Telephone*
Mobile
Cover Required From
Renewal Premium
Title
Mr
Mrs
Miss
Ms
Full Name*
Primary Trade
Risk Postcode
Building No/ Name
Years Trading
Vehicles to be Covered
Does the Premises have a Timber Roof?
Does the Proposer Live on the Premises?
Premises Alarm Bell Only?
Premises Alarm a Digicom?
Premises protected by CCTV?
Premises Alarm is RedCare?
Premises Alarm is RedCare GSM/ DualCom?
Proposer Require Subsidence?
Propposer Require Accidental Damage?
Claims/ Losses in the last 5 years?
0
1
2
3
4
5+
Please provide details for all Claims or Losses: Date, Reason and Loss Amount
motortraderinsurance.eu
,
motor trader insurance
and
insurance services
are all represntations of
Lionheart
Insurance
Lionheart Insurance
Services Ltd is regulated by the Financial Services Authority, Ref 499589