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Online request for quotation

Please note we do not provide insurance for:
- Motorcycles
- Touristenfahrten Nordschleife
- Certain countries outside the EU/UK
- Cars with a value under 15.000 euros

ONLINE REQUEST FOR QUOTATION - Transit Insurance

General

Beneficiary

Confirm

Fields marked with an * are compulsory

General

Salutation Mr. Mrs.

Applicant / Contact person *

Business/Consumer

Charge VAT?

Company name

Address*

Address 2:

Zip*

City*

Country:*

State / county / canton

Phone*

Email*

Confirm E-mail *

Password*

Repeat Password*

Desired currency for this quotation

Select the type of insurance: *

Beneficiary

Is the beneficiary known?* No Yes Applicant

(Company)Name: *

Address:*

Address 2:

Zip:*

City:*

Country: *

State / county / canton:

Forwarder

Is the forwarder known?* No Yes Applicant

Company: *

Address:*

Address 2:

Zip:*

City:*

Country: *

State / county / canton:

Risk location(s)

Address:*

Address:

Zip:*

City:*

Country: *

Please select the type of premises

Premises: *

Construction: *

Roofing: *

In an area which is free of flooding and not in the vicinity of any rivers, streams or tidal waters? *

Security measures * CCTV
Alarm system
Gate
Security staff
Windows with locks
Windows with catches
Fences/walls
Fire/smoke detectors/alarms
External doors with locks

Interest

Please complete the details of the shipped car(s) / goods

Please complete the details of the stored car(s) / goods

Please complete the details of the shipped & stored car(s) / goods

Car

Make / Model:*

Current value:* EUR

Chassis number:

Year:

Colour:

Are there any pre existing damages?

Please provide evidence of the pre existing damages by uploading the Bill of Lading, a Vehicle Check Sheet or images.Please provide evidence of the pre existing damages by uploading photos.

Risk location:

Spare Parts / Tools / Equipment

Type:

Description:

Total value:*

Upload Bill of Lading / Carnet

Transport Mode(s)

Are you requesting a quote for single transits or for an annual policy?

One-off transit Annual Policy

Please define the transport route per mode.

Transport Mode 1: *

Flight number : * TBC

AWB (Air Waybill) Number : * TBC

Vessel name : * TBC

Voyage Number : * TBC

From (Location) : *

To (Location) : *

Upload Bill of Lading / Carnet *

Please upload a Vehicle Check Sheet or photos of the vehicle *

Estimated number of transports per annum:

Transport: *

Please enter the period of insurance (transport period)

Please enter the required inception date.

Start (Date) : *

End (Date) : *

Other

Ambassador Code

Add attachment

Remarks

Gullwing Insurance reserves the right to ask for photos of the vehicle(s) that are requested to be insured before deciding whether or not they wish to accept the risk on behalf of the Underwriter. Please note that in the case of International transport outside Europe we cannot insure a higher value than the carnet value.

I declare that I have read and fully understand the above.

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