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Ice Cream Van Insurance Quote Request
Title
Mr
Mrs
Ms
Miss
First Name
Surname
House Number or Name
Postcode
Contact Email
Contact Phone Number
Best Time to call back
Morning
Noon
Afternoon
Saturday morning
Any office hours
Cover/Renewal Date
Registration Number
Ice Cream Van make
Ford
Mercedes Benz
Bedford
Other
Model
Fuel
Diesel
Petrol
Number of Seats
1
2
3
4+
Date of First Registration
Full Vehicle value (including modifications)
£
Where is the vehicle kept overnight?
Car Park
Carport
Garaged
Locked Building
Locked Compound
On Drive
Private Property
Public Road
Postcode where kept
Owner
Insured
Spouse
Company
Other
Annual Mileage
miles
Driving Restriction
Insured only
Insured & Spouse
Named Drivers
Any Driver over 25
Any Driver
Driver Details
DOB
Licence Date
DOB
Licence Date
DOB
Licence Date
DOB
Licence Date
Details of Past Claims - include driver's name,
date of incident, claim costs and brief
description (if none enter 'none')
Details of any driver's driving convictions -
include driver's name, offence code,
number of points, date of offence
and fine (if none enter 'none')
Years NCD available for this vehicle
0
1
2
3
4
5
6
7
8
9+
Years NCD available on another policy
e.g. private car
0
1
2
3
4
5
6
7
8
9+
Definitions and Abbreviations
DOB
- Date of Birth
NCD
- No Claims Discount