Cargo Quotation Form

Name**

Phone**

Fax

E-mail**

**please be sure to supply your Name, telephone number (including area code) and email address so that we may respond to your enquiry.

My business is

Exporter		Bank
Importer		Manufacturer
Insurance Broker		Distributor
Select more than one if necessary

The quotation is for

Details of the risk

Assured's name

Nature of the business

Goods to be insured

Importing from

Exporting to

UK distribution

Conveyance limit

Insured turnover

Loss record (last three years). If there have been no claims enter "none"

Any other information

I would like to receive occasional news on insurance related matters from Lovat by email YesNo

You have a right to privacy and information you supply to us will be retained for the use of Lovat only.

Where necessary part or all of that information may be passed to insurers for the sole purpose of negotiating insurance on your behalf.