Fleet Quote
About You
Name
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How do you wish us to contact you?
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Company Name
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Type of Business
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Contact Telephone
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Mobile Number
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Email Address
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Home Address
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Home Postcode
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Cover Details
Cover Start Date
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Cover Required
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Do you currently have a Fleet policy?
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Fleet Details
Fleet Type
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Number of Vehicles in Your Fleet
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Driving Requirements
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How many of your drivers are 25 years old and under?
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Do you use agency, temporary or casual drivers?
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Vehicle Details (Make/Model/Reg Number) - optional
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Driver Management
For each new driver who will drive a vehicle part of your fleet, do you do any of the following:
Have an application form completed?
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Take a copy of their driving licence?
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Obtain details of any previous motoring accidents or convictions?
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Has anyone who will be driving the vehicles obtained any motoring convictions / endorsements on their licence? If so, please specify.
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How did you hear about us?
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© Coversure Insurance Services 2008
Boardmatter Enterprises Ltd t/as Coversure Insurance Services is authorised and regulated by the Financial Services Authority. Ref: 2775330.
FSA registration number: 307589
Registered address Registered office: 9 Oxford Street Kidderminster Worcester DY10 1BB

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