Car Wash Insurance

Please fill in ALL fields marked with a *

Please select the insurance cover/s
Please select the insurance cover/s	Yes	No
Fire and Perils	Fire and PerilsYes	Fire and PerilsNo
Business Interruption	Business InterruptionYes	Business InterruptionNo
Burglary	BurglaryYes	BurglaryNo
Money	MoneyYes	MoneyNo
Glass	GlassYes	GlassNo
Public Liability	Public LiabilityYes	Public LiabilityNo
Management Liability	Management LiabilityYes	Management LiabilityNo
Equipment Breakdown	Equipment BreakdownYes	Equipment BreakdownNo
Cyber	CyberYes	CyberNo

Do you wish cover for multiple locations?

Do you wish cover for multiple locations? Yes No
Please Note:

You will need to complete one form per location.

Please provide ‘Location 1’ in the first form, ‘Location 2’ in the second and so on.

We will collate the information for quotation purposes.
This form is for location number:
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