Octagon House, 18 Nash Green, Hemel Hempstead, Herts. HP3 8AA        Phone :   01442 242 400
Fleet
 
Contact Name :
Company Name :
Company Address :
Contact Telephone :
Mobile Number: :
Fax Number: :
Email :
Number of Years Trading :
Business/Trade :
Are your vehicles currently insured as a fleet? :
Yes: No
Cover required from / Renewal Date (dd/mm/yy) :   
Current Insurer :
Current Premium : £
Best Quote Obtained : £
Number of Vehicles :
Cover Required :
Driving Requirements :
How many of your drivers are 20 years of age and under? :
How many of your drivers are between 21 & 24 years of age? :
How many of your drivers are between 25 & 29 years of age? :
Do you use agency, temporary or casual drivers? :

For each new driver who will drive on your business, do you :
Have an application form completed? :
Yes: No
Take a copy of their driving license? :
Yes: No
Obtain details of any previous motoring accidents or convictions? :
Yes: No
Has anyone who will be driving the vehicles obtained any motoring convictions / endorsements on their licence. If so, please specify.