Rental

Home Rental

Rental -Commercial

  • POLICY NUMBERCERTIFICATE NUMBER
  • Date Format: MM slash DD slash YYYY
  • HomeWorkCell
  • STATE PERIOD OF DRIVING EXPERIENCE:NUMBER OF DRIVERS EMPLOYED:
  • TERMS OF INSURANCE FOR: (Months)FromTo
  • Registered Letters and NumbersMake of Vehicle & Type of Body & ColourHorse Power (Makers Rating)Horse Power (Tonnage)Year of ManufactureCarrying Capacity (goods)Carrying Capacity (Persons)Proposer’s Estimate of Present Value of Vehicle (including accessories) 
  • Chasis NoEngine No
  • 1. State fully the purpose for which the vehicle/s will be used
  • b) Whether new or second handc) Paid Price
  • Percentage {%)
  • 11. Has any Company or Underwriter either in respect of you or your partner ever.
  • Total Number of Motor Vehicles Owned By ProposerTotal Number Of Accidents And LossesPAID/OUTSTANDINGNo of Damage to motor Vehicles ownedAmountThird Party (No:)Third Party (Amount)Others (No)Others (Amount) 
  • If vehicle is being used or driven by members of your family or household or Directors or Partners or others including employees, give full details below
    ANY LICENCED DRIVER 25 YEARS OR OLDER WITH 5 YEARS OR MORE DRIVING EXPERIENCE
  • NAME OF DRIVERAGEDRIVING EXPERIENCERELATION TO PROPOSERNUMBER OF ACCIDENTS DURING THE PAST 5 YEARS 
  • I/We desire to insure with GENERAL INSURANCE COMPANY LIMITED the motor vehicle/vehicles described in the above Proposal and I/We hereby warrant that the above statements and particulars are true and I/We have not suppressed misrepresented or misstated any material fact and I/We agree that the declaration shall be the basis of the contract between me/us and the Company. I/We further agree that if this proposal in any particular is filled in by you or any other person such person shall be deemed my/our agent and not the agent of the Company. I/We further declare that I/We have read and understood all particulars entered herein and I/We have signed this after verifying the same to be true and complete in all respects. I/We further declare that I/We am/are willing to accept the Company’s policy subject to the following clauses and warranties;
  • Dated thisDay ofYearPlace
  • :