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Quotes - Motorcycle Insurance


Date of Birth:
/ /
yyyy   mm   dd
M1 License Date:
/ /
yyyy   mm   dd
M2 License Date:
/ /
yyyy   mm   dd
M License Date:
/ /
yyyy   mm   dd
Did you take a Riders Training Course:
Yes     No
Any tickets in the last three years?
Yes     No
 If yes, how many?
Any claims in last 6 years?
Yes     No
Apart from liability, what other coverage are you looking for with respect to the bike?
Note: Comprehensive includes Vandalism, Missiles and Falling or Flying Objects whereas Specified Perils doesn’t
Liability Limit:
Collision Deductible amount:
Comprehensive Deductible amount:
   
Specified Perils Deductible amount:
Year, make and model:
# of CC's
Approximate value of bike:
Modified or Customized:
Yes     No
Current Insurance Company for your bike:
How many years with current insurance company
Do you belong to any Riders Associations or Clubs?
Yes     No

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