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Showmans Commercial Vehicle Insurance - Quote Request

Request a quotation from LFC Insurance Services, by filling in as much of the form below as possible.
Fields marked with a red asterix are mandatory.

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PROPOSER

Title:*

First Name:*

 

Surname:*

Address:

 

City/Town:

County:

Postcode:

Country:

Home Telephone No:*

Work Telephone No:

Fax No:

Mobile No:

Email Address:*

Best time to contact you:

 
All Occupations

Full Time:

Part Time:

Employers Business:

Period of insurance from:

Time (24 hrs)
  Date (DD/MM/YY)

Annual Mileage:

VAT Registered?

Yes No

Is the Vehicle kept in a locked garage over night at the address shown?

Yes No

Homeowner:

Yes No

Are you a member of the Showmans Guild?

Yes No
  
Vehicle Details

Make & Model:

Engine Size:

Max. Carrying Capacity:

Gross Vehicle Weight (GVW):

Year of Manufacture:

Left or Right Hand Drive:

Date of Purchase:

Number of Seats:

Registration Number:

Type of Body:

Transmission/Fuel:

Main Colour:

Present Value:

Price Paid:

Maximum Mileage for Period of Insurance:

Private
  Business

Is the vehicle imported?

Yes No

Mileometer Reading:

   
Cover and Use

Cover:

Comprehensive
Third Party Fire & Theft

Please indicate the Class of Use required:

Social Domestic & Pleasure Only
Carriage of Own Goods 
Haulage

Will you carry fare paying passengers? Yes No
Will the vehicle be used for mobile catering? Yes No
Will the vehicle be used on or at airfields? Yes No
Are goods to be carried? Yes No
Will the vehicle be used for carriage of livestock? Yes No
Will any corrosive, explosive, inflammable, toxic hazardous or dangerous goods be carried? Yes No
Will the vehicle have trailers attached? Yes No
Will the vehicle have any containers attached? Yes No
(Cover for trailers/containers is limited to third party whilst attached)
If Yes, please specify in full?
   
Ownership
Do you own the vehicle? Yes No

If No, please give details here?

Do you or any other member of your household own or insure any other vehicle? Yes No
If Yes, please give details here?
Date of purchase of vehicle:
   
Drivers

Who is the main user of the above vehicle?

Who will drive?

Yourself Only
Yourself and Wife/Husband only
Yourself and up to three Named Persons

Give full details below in respect of YOURSELF and ALL others who drive

Full name

All occupations
(including part time)

Employers Business

Date of Birth

Type of licence

Time licence has been held?

 

Will any person (other than yourself) drive the vehicle?

(a) be under 25 years of age?  Yes No
(b) hold a provisional licence? Yes No
(c) have had less than one year's driving experience? Yes No

If 'YES' full details must be shown:

Are you a smoker?

Yes No
 
Previous Experience

Have you or any person who may drive:-

(a) Lost an eye, limb or part of a limb, defective vision or hearing, any physical or mental infirmity, epilepsy, diabetes or any heart or other complaint? Yes No

(b) Any endorsement showing on their driving licence, or been convicted of any motoring offence during the past 5 years, or received a fixed penalty notice or have any prosecution pending? Yes No

(c) Been disqualified from driving or ever had their licence revoked? Yes No

(d) Been refused any motor vehicle insurance or continuation thereof or been required to pay an increased premium or had special conditions imposed by any motor insurer? Yes No

(e) During the last 5 years been involved in any accident, loss or claim irrespective of blame? Yes No

(f) Do you hold or have you ever held motor insurance? Yes No

(g) Are you claiming no claims discount? Yes No

If 'YES' give full details, including dates, circumstances and cost of any claims.
If 'YES' to disabilities have you advised DVLA?

   
   
 
   

Please note: all personal information provided on this form will be used solely for the purposes of answering your query or providing your quote, informing you of future offers and improving our services. This information will NOT be passed to any third party.

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Talk to us

Use our online form to contact us for more information, to ask a question or to get a quote – you will be contacted by one of our team within 2 hours.

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