Agricultural Vehicle Proposal

Would you like a quote for your Agricultural Vehicle? BJP are Agricultural Vehicle specialists, giving you all the information you need to make an informed choice.

If you would like a quotation please complete the enquiry form below and we will promptly respond or you can call us Monday to Friday 9am to 5pm 0118 979 2121

Name of Proposer:

Business Name if Applicable:

Telephone:

Email Address:

Address 1:

Address 2:

Town/City:

County:

Post Code:

Are you the registered owner?

Name of Main Driver:

Date of Birth:

Occupation:

Licence Type:

Motoring Convictions:

Medical Conditions:

Vehicle Registration:

Year Of Make:

Make/Model/Trim:

Vehicle Description RTV/Tractor:

Vehicle Value (£):

Purchase Date:

Overnight Location:

Level of Cover:

No Claims Discount at this renewal (Years):

Vehicle Use (eg. Own farm use or agricultural contracting):

Personal Use:

If other please specify with the percentage of usage for each category:

Business Use:

If other please specify with the percentage of usage for each category:

Additional Drivers or Vehicles? (Click Here)

Please Advise if the vehicle will be used for the following

Carriage of another persons goods for hire or reward?
Commercial Travelling or Market Trading
Carriage of hazardous goods
Motor trade / vehicle recovery
Crop spraying other then on proposers own land
Tree felling other then on proposers own land
Haulage of trees or timber on road or public highway
Carriage of passengers for hire or reward
Airside or within the confines of an airport

Please provide details if yes to any of the above:

Has the proposer or any person who will drive

Held a full UK licence / appropriate licence for the type of vehicle being proposed for less then 12 months?
Been a resident outside of the UK during the last 3 years?
Ever suffered from any medical condition or infirmity which might affect the ability to drive a motor vehicle as defined in DVLA leaflet D100?
Ever been convicted of, or have pending prosecution or have been cautioned, for any motoring offence or sustained a fixed penalty?
Made an insurance claim, or been involved in any accident or suffered any loss in connection with any motor vehicle, regardless of blame, in the last 3 years?
Ever been refused insurance, had insurance cancelled, or had special terms imposed by a previous insurer?

Please provide details if yes to any of the above:

When do you require your cover to start?

Current Insurer:

Renewal Premium:
If you are looking to find a cheaper quotation for this forthcoming year, giving us a target will help us to help you.

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