HOME ABOUT FAQ & MEDIA INSURANCE TERMS LOCATION TESTIMONIALS CONTACT BUSINESS INSURANCE        Professional Indemnity        Liability Insurance        Office Insurance        Shop Insurance        Property Owners Insurance        Tradesmen Insurance        Retail Insurance               HOME INSURANCE        Request a Quote               UNOCCUPIED PROPERTY        Unoccupied Houses        Unoccupied Commercial Property                      TRAVEL INSURANCE        Single Trip        Annual Multi Trip        Extended Stay               MOTOR INSURANCE        Private Motor Insurance        Commercial Vehicle Insurance        Motor Fleet Insurance                 Private Motor Commercial Vehicle Motor Fleet          Small Fleet Insurance Quote          Please complete this form to enable us to obtain a car quote for you. If you don't feel like completing the whole form just give us your phone number and we will contact you. ( * required fields )        Name (required) Company Phone (required) Email (required) Address          Policy details:          Type of cover required Select...Third Party OnlyThird Party Fire& TheftComprehensive          Windscreen cover yes no Are the goods carried your own goods? yes no          If no, please describe the goods that are going to be carried/ do you subcontract? Drivers        Are all drivers over 25 and do they all hold a full licence?* yes no        If no, please submit the drivers' details here (Name, DOB, Type of licence, occupation, details of claims, accidents etc)        *Our policies are normally based on Open Drive basis 25-70 with a full CLEAN/CLEAR licence. Policy holder is responsible to insure all drivers comply with the above.        Vehicles details          Please submit the details of the vehicles that you want to insure under your fleet policy (remember, your policy can include DIFFERENT types of motor vehicles e.g. car, van, lorry, motorcycle)                   Registration, Make, Model, Engine Size, Value, No Claims Bonus Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6 Vehicle 7 Vehicle 8 Vehicle 9          Details of claims, losses, accidents, convictions.          Have you or anyone who to your knowledge might be driving the vehicles have ever had any claims/ accidents/ losses/ convictions? yes no        If yes, please submit the details in the boxes below        Date/ Brief Details/ How much was paid out? Event 1 Event 2 Event 3 Event 4 Event 5        Other details        This form is for quotation purposes only and is not confirmation of a quote or insurance cover. Insurance cover will only commence on receipt of a completed proposal form, payment and written confirmation from Martin & Garvan Insurances.

Martin & Garvan Insurances Ltd is regulated by the Central Bank of Ireland.        Martin & Garvan Insurances, 96 Upr. Drumcondra Road, Dublin 9          Phone: +353 (01) 837 9276        Fax: +353 (01) 837 6548        Email: info@margarv.ie                                                Powered by: go2web