Quote for Commercial Catering Vehicle/Ice Cream Vehicle/Towing Vehicle Insurance
Client / Cover Details
Inception Date
*
-
Day
-
Month
Year
Date
What is the Business Status?
*
Please Select
Sole Trader
Partnership
Limited Company
Non-Limited Company
Charity Organisation
Limited Liability Partnership
Proposers name and trading name in full
*
Title
*
Please Select
Mr
Miss
Mrs
Ms
Other
If Other
*
Name
*
First Name
Last Name
Gender
*
Please Select
Female
Male
Not Applicable
Date of Birth
*
-
Day
-
Month
Year
Date
Phone number
*
Please enter a valid phone number
Email
*
example@example.com
Correspondence Address
*
Street Address
Street Address Line 2
City
County
Postal / Zip Code
Date Business Established
*
-
Day
-
Month
Year
Date
Agency Drivers
*
Yes
No
Product Type
*
Please Select
Catering Van
Ice Cream Van
Towing Vehicle
Other
If Other
*
Vehicles
Cover
Comprehensive Only
Registration
*
Make
*
Model
*
Cubic Capacity
*
Gross Vehicle Weight (GVW)
*
Fuel
*
Please Select
Diesel
Electric Diesel
Electric Petrol
Electric Only
Petrol
Transmission
*
Please Select
Automatic
Enhance Automatic
Manual
Body
*
Please Select
Van
Car
Lorry
Coach
Other
If Other
*
Seats
*
Year Manufactured
*
Left or Right hand drive
*
Please Select
Left
Right
Purchase Price
*
Value, Including All Permanent Fixtures & Fittings
*
Number of Axels
*
Please Select
2 axels
3 axels
4 axels
5 axels
6 axels
Usage
Driving Restrictions
*
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
*
Vehicle Modifications
*
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Additional Details
Overnight Postcode
*
Overnight Location
*
Please Select
Car Park
Garaged
Private Property
Public Road
Locked Building
Locked Compound
On Drive
Other
If Other
Owner or Keeper
*
Please Select
Company
Leasing Company
Proposer
Other
If Other
Date of Purchase
*
-
Day
-
Month
Year
Date
No Claims Bonus Year
*
Please Select
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
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30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Protected NCB Required
*
Yes
No
UK Registered
*
Yes
No
Personal Import
*
Yes
No
+ Additional Vehicle
Cover
Comprehensive Only
Registration
Make
Model
Cubic Capacity
Gross Vehicle Weight (GVW)
Fuel
Please Select
Diesel
Electric Diesel
Electric Petrol
Electric Only
Petrol
Transmission
Please Select
Automatic
Enhance Automatic
Manual
Body
Please Select
Van
Car
Lorry
Coach
Other
If Other
Seats
Year Manufactured
Left or Right hand drive
Please Select
Left
Right
Purchase Price
Value, Including All Permanent Fixtures & Fittings
Number of Axels
Please Select
2 axels
3 axels
4 axels
5 axels
6 axels
Usage
Driving Restriction
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
Vehicle Modifications
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Driving Restriction
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
Vehicle Modifications
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Additional Details
Overnight Postcode
Overnight Location
Please Select
Car Park
Garaged
Private Property
Public Road
Locked Building
Locked Compound
On Drive
Other
If Other
Owner or Keeper
Please Select
Company
Leasing Company
Proposer
Other
If Other
Date of Purchase
-
Day
-
Month
Year
Date
No Claims Bonus Years
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Protected NCB Required
Yes
No
UK Registered
Yes
No
Personal Import
Yes
No
+ Additional Vehicle
Cover
Comprehensive Only
Registration
Make
Model
Cubic Capacity
Weight (kg)
Fuel
Please Select
Diesel
Electric Diesel
Electric Petrol
Electric Only
Petrol
Transmission
Please Select
Automatic
Enhance Automatic
Manual
Body
Please Select
Automatic
Enhance Automatic
Manual
Other
If Other
Seats
Year Manufactured
Left or Right hand drive
Please Select
Left
Right
Purchase Price
Value, Including All Permanent Fixtures & Fittings
Number of Axels
Please Select
2 axels
3 axels
4 axels
5 axels
6 axels
Usage
Driving Restriction
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
Vehicle Modifications
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Driving Restriction
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
Vehicle Modifications
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Additional Details
Overnight Postcode
Overnight Location
Please Select
Car Park
Garaged
Private Property
Public Road
Locked Building
Locked Compound
On Drive
Other
If Other
Owner or Keeper
Please Select
Company
Leasing Company
Proposer
Other
If Other
Date of Purchase
-
Day
-
Month
Year
Date
No Claims Bonus Year
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Protected NCB Required
Yes
No
UK Registered
Yes
No
Personal Import
Yes
No
+ Additional Vehicle
Cover
Comprehensive Only
Registration
Make
Model
Cubic Capacity
Weight (kg)
Fuel
Please Select
Diesel
Electric Diesel
Electric Petrol
Electric Only
Petrol
Transmission
Please Select
Automatic
Enhance Automatic
Manual
Body
Please Select
Automatic
Enhance Automatic
Manual
Other
If Other
Seats
Year Manufactured
Left or Right hand drive
Please Select
Left
Right
Purchase Price
Value, Including All Permanent Fixtures & Fittings
Number of Axels
Please Select
2 axels
3 axels
4 axels
5 axels
6 axels
Usage
Driving Restriction
Please Select
1 Named Driver
2 Named Drivers
3 Named Drivers
4 Named Drivers
5 Named Drivers
Insured Only
Insured & Spouse
Any driver Excluding Drivers Under 25
Any Driver Excluding Drivers Over 30
Other
If Other
Annual Mileage
Vehicle Modifications
Please Select
No Electricals
Refrigeration
Oven/Boiler
Deep Fat Fryer
Naked Flame
Other
If Other
Additional Details
Overnight Postcode
Overnight Location
Please Select
Car Park
Garaged
Private Property
Public Road
Locked Building
Locked Compound
On Drive
Other
If Other
Owner or Keeper
Please Select
Company
Leasing Company
Proposer
Other
If Other
Date of Purchase
-
Day
-
Month
Year
Date
No Claims Bonus Year
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Protected NCB Required
Yes
No
UK Registered
Yes
No
Personal Import
Yes
No
Driver Details
Relationship to Proposer
*
Please Select
Business Partner
Daughter or Son
Director
Employee of Proposer
Employer of Proposer
Family, Other, Parent
Proposer
Spouse
Unrelated
Other
If Other
*
Permanent UK Resident?
*
Yes
No
Title
*
Please Select
Mr
Miss
Mrs
Ms
Other
If Other
*
Name
*
First Name
Last Name
Gender
*
Please Select
Female
Male
Not Applicable
Date of Birth
*
-
Day
-
Month
Year
Date
Marital Licence
*
Please Select
Divorced
Married
Married - Common Law
Not Available, Partnered
Partnered Civil
Separated
Single
Widowed
Driving Licence
Type
*
Please Select
EEC Licence (EU)
Foreign
Full (UK)
International Lic
Other, Provisional (UK)
Rest. 3 yrs or +
Rest
Inder 3 Yrs
Other
If Other
*
Date Passed
*
-
Day
-
Month
Year
Date
Employment Type
*
Please Select
Employed
Self Employed
Retied
Unemployed
Other
If Other
*
Employment Type
*
Please Select
Mobile Caterer
Ice Cream Vendor
Other
If Other
*
Other
Has the Driver been convicted or charged (but not tried) of any non-motoring offences?
*
Yes
No
Has Any Motor Insurance Been Cancelled, Voided or refused?
*
Yes
No
Have you had any Motor Convictions in the last 5 years?
*
Yes
No
Motor Convictions
(Any motor convictions within the last 5 years)
Date of Convictions
*
-
Day
-
Month
Year
Date
Offence Code
*
Please Select
AC10
AC20
AC30
BA10
BA30
BA40
BA60
CD10
CD20
CD30
CD40
CD50
CD60
CD70
CD80
CD90
CU10
CD20
CD30
CDD40
CD50
CD80
DD10
DD40
DD60
DD80
DD90
DG10
DG40
DG60
DR10
DR20
DR30
DR31
DR40
DR50
DR60
DR61
DR70
DR80
DR90
IN10
LC20
LC30
LC40
LC50
MR09
MR29
MR39
MR49
MR59
MS10
MS20
MS30
MS50
MS60
MS70
MS80
MS90
MW10
PC10
PC20
PC30
SP10
SP20
SP30
SP40
SP50
TS10
TS20
TS30
TS40
TS50
TS60
TS70
TT99
UT50
Penalty Points
*
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
Fine Amount
*
Have you had any Motor Claims in the last 5 years?
*
Yes
No
Motor Claim
(Any Motor claims or incidents within the last 5 years, fault or non-fault on any vehicle)
Date of Incident
*
-
Day
-
Month
Year
Date
Incident or Loss Type
*
Please Select
Accident
Fire
Theft
Vandalism
Windscreen
Other
If Other
*
Drivers Fault
*
Yes
No
Loss of NCD
*
Yes
No
Claim Outstanding
*
Yes
No
Claim on this Risk
*
Yes
No
Linked to Conviction
*
Yes
No
Claim on this Risk
*
Yes
No
Linked to Conviction
*
Yes
No
Claim Detail
*
Injury Details
*
Do you have any Medical Conditions that are notifiable to the DVLA?
*
Yes
No
Medical Conditions
(Only that are notifiable to the DVLA)
Medical Conditions
*
DVLA Aware
*
Yes
No
Any Additional Information?
Spacer
+ Additional Convictions
Motor Convictions
(Any motor convictions within the last 5 years)
Date of Convictions
-
Day
-
Month
Year
Date
Offence Code
Please Select
AC10
AC20
AC30
BA10
BA30
BA40
BA60
CD10
CD20
CD30
CD40
CD50
CD60
CD70
CD80
CD90
CU10
CD20
CD30
CDD40
CD50
CD80
DD10
DD40
DD60
DD80
DD90
DG10
DG40
DG60
DR10
DR20
DR30
DR31
DR40
DR50
DR60
DR61
DR70
DR80
DR90
IN10
LC20
LC30
LC40
LC50
MR09
MR29
MR39
MR49
MR59
MS10
MS20
MS30
MS50
MS60
MS70
MS80
MS90
MW10
PC10
PC20
PC30
SP10
SP20
SP30
SP40
SP50
TS10
TS20
TS30
TS40
TS50
TS60
TS70
TT99
UT50
Penalty Points
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
Fine Amount
+ Additional Claim
Motor Claim
(Any Motor claims or incidents within the last 5 years, fault or non-fault on any vehicle)
Date of Incident
-
Day
-
Month
Year
Date
Incident or Loss Type
Please Select
Accident
Fire
Theft
Vandalism
Windscreen
Other
If Other
Drivers Fault
Yes
No
Loss of NCD
Yes
No
Claim Outstanding
Yes
No
Claim on this Risk
Yes
No
Linked to Conviction
Yes
No
Claim on this Risk
Yes
No
Linked to Conviction
Yes
No
Claim Detail
Injury Details
Medical Conditions
(Only that are notifiable to the DVLA)
Medical Conditions
DVLA Aware
Yes
No
Any Additional Information?
Add Additional Driver
If you would like to add an Additional Driver, Please provide details below.
Add Additional Vehicle
If you would like to add an Additional Vehicle, Please provide details below.
Once this has been Completed press send, details will be sent to Giles Insurance Consultants, we aim to get back to you within 48 hours.
Submit
Have you had any Motor Claims in the last 5 years?
*
Yes
No
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