Seico Insurance Consultants

Commerical Vehicle Insurance

Thank you for using the vehicle insurance quotation form. After submitting this form, you will be contacted by us with the most competitive for your policy within the next 24 hours. Different companies have different terms and conditions so it is important to check the quotes you recieve.

About Your Business Company Name:
E-mail Address:
Postal Address:
Post Code:
Contact Name and Number:
Date of Birth
Occupation/Business Description:
About Your Vehicle make/model:
Body type:
Engine Size
Year of make
Value
Registration number
Does the vehicle have alarm or immobiliser	yes no
If yes, then Is the Alarm/Immobiliser Thatcham 1,2 or neither
Where is vehicle kept at night (e.g. road, garage, driveway)
Who owns the vehicle
Gross Vehicle Weight
Annual Mileage
Level of Cover Required, Comprehensive, Third Party Fire & Theft, Third Party
No Claims Years Available (1-5)
About the driver
Who Will Be Driving Vehicle (insured only, Insured & Spouse, Named, Any)	Insured only Insured & spouse Named Any
Driver Name
Address
Date of Birth
Occupation
Please give details of any Accidents Thefts or Losses occurring within last 5 years
Please give details of Convictions, Pending Convictions and Bans within last 5 years
Any other relevant information (include details for any other known driver)

Preferred Method of Payment:	Cheque Credit Card Direct Debt