MOTOR TRADE

1. Name of Proposer and Trading Title:
2. Address of the premises:
Post Code:	Tel. Number:
e-mail (if you have any):
3. Description of Business:
4. Date Established:
5. Type of premises:
6. Does your premises have it's own lockable entrance:	Yes No

PART A - ROAD RISK

Proposers involvement in Motor Trade

Buying / Selling / Wholesale:	%	Car breaking / Scrap:	%	Valeting Steam Cleaning:	%
Repairing and Mechanical:	%	Vehicle deliveries:	%	Breakdown / Recovery:	%

Other Specify:


Cover Required:

Maximum capacity in cars:		Date Established:		Avarge number of vehicles handled per year:
Annual T/O: £		Registered for VAT:	Yes No
Limit any one vehicle:	Own Vehicle:	£	Customer Vehicle: £
Average value of::	Own Vehicles:	£	Total value of own Vehicles:	£

No claims discount years earned on:		Does Proposer mainly deal in sports or high performance vehicles:	Yes No
Imported modified kit cars:	Yes No
Do you require demonstration:	Yes No
Do you require customer loan vehicle cover:	Yes No
Commercial vehicles in excess of 3.5 tons GVW:	Yes No	If "Yes" state capacity of vehicles:
Do you require breakdown recovery?	Yes No
Do you require motorcycles recovery	Yes No	If "Yes" state max: cc and state value:	£

Authorised driving:

Named drivers:	Age:	Occupation if not full time MT	State if principal employee / family:	Date U.K. driving test passed:	Usage:	Convictions, physical, defects, accidents/claims. If none state none
1.
2.
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5.
6.

PART B - NON MOTOR RISKS / INTERNAL RISKS

TRADE PREMISES COVER	Yes No
Address as Part A
Give details of Construction of Premises. If your premises are not self contained, please give details.
THEFT PROTECTIONS
Give brief details of physical protections and perimeter security.
BURGLAR ALARM
Is there a burglar alarm under your sole control	Yes No
If "Yes" type of the alarm:
ARE ALL VEHICLES SECURED AT NIGHT WITHIN THE LOCKED BUILDING	Yes No
It NO what percentage remain in the open %	and how are such vehicles protected from theft! vandalism?

Are any vehicles parked on the road outside the trade premises at night	Yes No

MATERIAL DAMAGE
Total value of own vehicles	£	MONEY	Limited any one carrying	£
Total value of customer’s vehicles	£		Annual carryings	£
Buildings / tenant’s improvements and decorations	£		Safe limit - out of hours	£
Fixed plant and equipment	£		Limit during business hours	£
Stock ex radios/tobacco/video/wine & spirits	£	GLASS	On external glass	£
Stock other specify	£		On signs / canopies	£
Portable tools / employees’ tools	£	GIT	Goods in Transit(GIT) (max per vehicle)	£
Gross Profit (per year)	£		NO. of vehicles
LIABLITIES
Annual Turnover (ex VAT)	£
Annual wages paid to manual employees	£ PA
Self employed labour / casual labour	£ PA
Principal / Directors / Partners drawings and salaries	£ PA
All other non manual employees	£ PA
Total Wages	£

ADDITIONAL INFORMATION AND DETAILS OF ALL LOSSES SUSTAINED UNDER ABOVE SECTIONS. If none - state NONE.

PART C - LIABILITY

This covers your legal liability to customers and members of the public for injury to them or
damage to their property arising from your declared activities at your premises or whilst working away

Do you require cover for:
Public Liability	Yes No	Standard indemnity is £1,000,000. Cover required:
Products Liability	Yes No	Standard indemnity is £1,000,000. Cover required:
Service Indemnity	Yes No	Standard indemnity is £250,000. Cover required:
Sales Indemnity	Yes No	Standard indemnity is £1,000,000. Cover required:
What is your projected annual turnover	£	What is your projected annual wage roll	£

Have you previously been insured for liability risks	Yes No
If "Yes", state name of Insurer		period of cover
WELDING / CUTIING / SPRAYING

Do you weld or cut on your own premises	Yes No	Away from your premises	Yes No
Do you spray on your own premises	Yes No	Away from your premises	Yes No
EMPLOYER’S LIABILITY
Do you require cover for Employer’s Liability	Yes No	Standard indemnity is £10 Million
Estimated annual wage for :-	Clerical £	Manual £	Work Away £

Have you ever been prosecuted under the Factories Act, the Health & Safety at Work Acts or other Statutory Regulations Yes No

Have you previously been insured for Employer’s Liability cover	Yes No
If "Yes" state name of Insurer:

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