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ONLINE QUOTATION FORM - COMMERCIAL VEHICLE INSURANCE
Particulars
*
Indicates required field
Registered Company's Name
*
Contact Person
*
Contact Number
*
Email
*
Nature of Business
*
Vehicle Details
Vehicle Number
*
Vehicle Type
*
Lorry
Van
Pick-Up
Bus
Tipper
Attachments
*
None
Hood
Canopy
Crane
Twin Cabin
Tailgate
Refrigerated
Box
Insurance Details
Existing Insurer
*
Renewal Date : (DD/MM/YYYY)
*
NCD Upon Renewal
*
0%
10%
15%
20%
Claims Experience For The Past 3 Years
*
No
Yes
If yes, Date of Claim: (DD/MM/YYYY)
*
Own Damage Claim Amount, if any (S$) :
*
Third Party Damage Claim Amount, if any (S$):
*
Type of Coverage Required :
*
Comprehensive
Third Party Fire & Theft
Third Party Only
Comment
*
Please tick below to give consent
*
I consent Safe Harbour to contact me
Consent for Safe Harbour Assurance Agency to call me for any further clarification and/ or providing quotation pertaining to the service that I enquire.
Submit
Motor
Motor Insurance Quotation Form
Commercial Vehicle Quotation Form
Personal
Home Insurance
>
Home Insurance Quotation Form
Personal Accident Insurance
>
Personal Accident Insurance Quotation Form
Domestic Maid Insurance
>
Domestic Maid Insurance Quotation Form
CONNECT
SATISFACTION