Welcome to Waveney Insurance Brokers

Removers & Storers Insurance

Complete the short form below to get a quotation or call  01362 850707

Existing Insurer Details
Renewal Date:		DD/MM/YY
Renewal Premium
Insurer
Customer Details
Proposer's Name
Address
Number/Name
Street
Town/ County
Postcode
Telephone Number
Email address
Web Address
Memberships
Advise if members of		Select All That Apply BAR The Guild Of Removers & Storers SSA UK Any Other
Other Memberships
Cover
Cover		Select Comprehensive TPFT TPO
Vehicles
Make	Year of Make	Gross Vehicle Weight		Value of Vehicle		Years of NCD
Claims Experience
How long has the proposer been in business yrs				Any claims in last 3 years?				yes
								no
If yes, please provide following details:
Type of Claim		Payment made £				Date
Activities
Domestic Removals/Storage	Continental Removals/Storage	International Shipments			Self Storage
Archive Storage	Maid Service	Any Other	Specify Other
Estimated Turnover		Number Of Vehicles