Trading Name 1:
Do you have more than one trading name?
Trading Name 2:
Trading Name 3:
Trading Name 4:
Trading Name 5:
Principal First Name:
Principal Last Name:
Bay of Plenty
(if different from above)
Help us to understand your business a little better
Has any insurer ever refused you cover or not invited renewal?
If Yes, please provide full details and circumstances;
Do you currently refer or discuss insurance related questions with your customers?
Years in Business
Number of vehicles:
What type of Contents do you usually Carry?
Household Personal Effects
Commercial/Industrial (ie; Office, Factory relocations)
Details of General Freight carried:
(ie; Clothing, Machinery, Chemicals)
Any other information that you think might help us understand your business (ie What Type of Insurances your Business currently holds where we could assist related to CARTS):
* Indicates a mandatory field.
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