Important – please read carefully
Please read the following information carefully. It is a record of Statements made and information
given by you and forms the basis of your contract of insurance.
If any of the following details appear to be incomplete or incorrect please contact your broker within
the next seven days. Failure to do so could invalidate your insurance. You will be advised of any
changes in the premium or terms and revised Statement will be issued to you. It is important that
You tell us as soon as reasonably possible about changes to any of the information You have
provided.
Intermediary: Quote Me Today Policy Number: MT204924753
Your Name: Mrs Muniba Zufeer T/A
Motor Trade Car Sales
Occupation:
Home address: 281, Horninglow Road North, Postcode: DE13 0SS
Burton-on-Trent,
Staffordshire, England
Trade address: 281, Horninglow Road North, Postcode: DE13 0SS
Burton-on-Trent,
Staffordshire, England
Telephone: 07498627732
Email: [email protected]
Cover Details
Inception Date 20/06/2023 Time Cover 14:54
commencing:
Cover Type: Comprehensive Driving
restrictions:
Level of indemnity: £7500 No claims 0 years
discount:
Excess Compulsory £350
Increased: £750
Demonstration Cover
included: Yes
Business Details
Is the business involved with any of the following:
Repossession of vehicles? No
In the event of an accident or claim please ring: 01908 755 950
Collection and delivery of vehicles for a fee? No
Vehicle salvage or car breaking No
Imported Vehicles No
High performance / sports vehicles? Yes
American / Canadian vehicles? No
Recovery vehicles? No
Kit built vehicles, vehicles that have been
customised, modified or supercharged? No
Drivers Details
Driver1 Proposer
Full Name: Muniba Zufeer
Date of birth: 15/05/1991
Additional Occupation: Car Sales
Resident in UK for more than 3
years: Yes
Type of licence held: Full UK
Licence Length: 3 years +
Driver2 Business Partner
Full Name: Mohammed Rizwan
Date of birth: 10/05/1994
Additional Occupation: Car Sales
Resident in UK for more than 3
years: Yes
Type of licence held: Full UK
Licence Length: 3 years +
In the event of an accident or claim please ring: 01908 755 950
Accidents Claims or Losses
Driver Name Date of Claim Type Description of Loss of
Acc/Loss Acc/Loss NCD?
None
Motoring Offences
Driver Name Offence Date Offence Ban Length if any (m)
None
Mohammed Rizwan 10/09/2020 SP50 0
Medical Conditions
Driver Name Condition Licence Restricted?
None
Have you or any named drivers either personally or in connection with any business you have
been involved in:
Ever been declined or refused insurance cover, had cover cancelled or
special terms applied No
Ever been convicted or charged (but not yet tried) with a criminal offence No
Ever been declared bankrupt or are the subject of any current bankruptcy
proceedings No
Declaration
I declare that I have taken reasonable care to answer all questions on this statement of fact
honestly and to the best of my knowledge. I understand that if I have not answered all questions
honestly and correctly my policy may be cancelled and/or my claim rejected or not paid in full. If
an answer has been given by any other person about myself or if this statement has been
completed by any other person on my behalf that person shall be my agent for that purpose. I
have read and agreed the answers to all questions on this form, whether in handwriting or not
and agree to accept a policy subject to the terms and conditions and exceptions contained
therein.
In the event of an accident or claim please ring: 01908 755 950
