REQUEST FOR QUOTATION (RFQ)
SEBUT HARGA
Vehicle Owner's Details | Maklumat Pemilik Kenderaan
*
Full Name
NRIC No | Company Reg No | Passport No
Vehicle Information | Maklumat Kenderaan
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Vehicle Registration No.
Vehicle Model
Transmission
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Car: Automatic
Car: Manual
Motorcycle
Cubic Capacity
*
150cc or 1.5L / 2.0L
Vehicle Location (Postcode)
*
Lokasi Kenderaan (Postkod)
Phone Number (Whatsapp)
*
Please enter a valid phone number.
Services Required | Servis Diperlukan
*
Please Select
Allianz Motor Insurance Only
Allianz Motor Insurance + Roadtax Delivery
Etiqa Takaful Motor Insurance Only
Etiqa Takaful Motor Insurance + Roadtax Delivery
Email
example@example.com
Upload Image (Registration Card / Covernote Copy)
Browse Files
Drag and drop files here
Choose a file
Image is required to support Chassis & Engine No verification. Make sure the image is clear and readable. Gambar diperlukan untuk pengesahan no Chassis & no Enjin. Sila pastikan gambar yang jelas dan boleh dibaca.
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of
I hereby confirm the information above is valid and acknowledge that I require the services of BARAKAH FL 88 ENTERPRISE and the Agency is entitled to commission of 10%. I will not be entitled to the rebate by proceeding.
Saya mengakui bahawa maklumat diatas adalah benar dan saya memerlukan perkhidmatan BARAKAH FL 88 ENTERPRISE dan Agensi berhak mendapat komisen sebanyak 10%. Saya tidak berhak mendapat rebat dengan meneruskannya.
Do You Agree to the Terms Above? | Adakah anda setuju dengan terma diatas?
*
Yes, Setuju
No, Tidak Setuju
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