Motor Fleet Insurance Quotation Form

CoverMarque is a trading style of Clear Insurance Management Limited which is authorised and regulated by the Financial Conduct Authority (FCA). You can check these details on the Financial Services Register by visiting the FCA’s website (www.fca.org.uk). Our FCA number is 307982. Registered in England and Wales, No. 3712209. Registered office: 1 Great Tower Street, London, EC3R 5AA.

Year	Make	Model	Registration	Current Market Value	Overnight Postal Code

Motor Fleet Insurance Quotation

Motor Fleet Insurance Quotation Form

Information You Must Disclose

GENERAL DETAILS

Vehicle Details

Additional Cover

CLAIMS AND OTHER INFORMATION

How did you hear about CoverMarque & Handling of your data

Wind Gust Checker

Covermarque

Contact Details

Driver Name	What was the Offence	Date of Offence