Personal Details

Name *
Trading Name *
Business Postcode *
Telephone *
Mobile
Email Address *

Your Business

Are you	Please Select Sole Trader Partnership Limited Company
Annual Turnover £
Year Established?
Full or Part Time?	Please Select Full Time Part Time
Trading From	Please Select Home Premises Mobile
Number of Proprietors, Partners or Directors	Please Select 1 2 3 4
Number of Employees	Please Select 1 2 3 4 5 6 7 8+
What is Your Business Type?	e.g. Vehicle Sales, repairs, valeting
What Vehicle Category do you work on?	e.g. Cars, Light Commercial, Motorcycles, CV's?
Do you carry out heat work?	Please Select Yes No e.g. soldering, welding
- If "Yes", is it on or off the premises?	Please Select On Off Both

Insurance Cover Required

Public Liability	Please Select 1 2 3 (£ million limit)
Sales and Service Indemnity	Please Select Yes No
Damage to customers vehicles	Please Select Yes No
Tools Cover	Please Select Yes No
Employers Liability	Please Select Yes No
Sub Contractors	Please Select Yes No