PERSONAL QUOTE

Name
Surname
Contact number
Identity number
Marital Status
Occupation
Email Address
Presently Insured
Yes No
 
Period Of Insurance
Insurance Company
Details of claims / losses in the past three years:

BUILDING AND HOUSEHOLD CONTENTS

Building 1
Sum Insured
Construction of Roofs
Construction of Walls
Building 2
Sum Insured
Construction of Roofs
Construction of Walls
Building 3
Sum Insured
Construction of Roofs
Construction of Walls
Contents 1
Sum Insured
Construction of roofs
Construction of walls
Burglar bars on all windows.
Security gate on external doors
Alarm with armed response
Secure complex + access control
Contents 2
Sum Insured
Construction of roofs
Construction of walls
Burglar bars on all windows.
Security gate on external doors
Alarm with armed response
Secure complex + access control
Contents 3
Sum Insured
Construction of roofs
Construction of walls
Burglar bars on all windows.
Security gate on external doors
Alarm with armed response
Secure complex + access control

UNSPECIFIED ALL RISKS

Sum Insured 1

SPECIFIED ALL RISKS

Item1 Sum Insured
Item2 Sum Insured
Item3 Sum Insured
Item4 Sum Insured

COMPUTERS & LAPTOPS

Item1 Sum Insured
Item2 Sum Insured
Item3 Sum Insured
Item4 Sum Insured

PERSONAL LIABILITY

R2 Million R5 Million R10 Million R20 Million

PERSONAL ACCIDENT

Option 1 - R 50,000
Option 2 - R100,000

MOTOR

Motor 1

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

Motor 2

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

Motor 3

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

Motor 4

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

MOTOR CYCLES

Motor Cycle 1

Make
Model
Year
Retail Value
Mileage
Regular Drive & D OB
Registered Owner
Overnight Parking
Vehicle Security

Motor Cycle 2

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

Motor Cycle 3

Make
Model
Year
Retail Value
Mileage
Regular Drive & D O B
Registered Owner
Overnight Parking
Vehicle Security

Motor Cycle 4

Make
Model
Year
Retail Value
Mileage
Regular Driver & D O B
Registered Owner
Overnight Parking
Vehicle Security

TRAILERS & CARAVANS

Trailer / Caravan 1

Make
Model
Year
Retail Value

Trailer / Caravan 2

Make
Model
Year
Retail Value

Trailer / Caravan 3

Make
Model
Year
Retail Value

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