FLC Insurance Services
FLC Insurance Services Ltd is one of
the leading company in UK. We are 
committed to provide our customers 
with best advice. We deal in 
Commercial insurance, personal 
insurance, property insurance and 
Vehicle insurance.

Tel: 020 8542 6999
 
Private Motor Quotion From

The Proposer
Title
   
First Name
Surname
Address
Post Code
Telephone
Mobile
UK Residency Years
Marital Status
Home Owner
DOB
Diving License
Taxi License
Years Held
Occuption
Local Authority
Work Post Code    
       
Driver History - Pleases delete
a) Convictions or pending prosecutions within in the last five years.  Yes  No
b) Disqualified, License suspended or revoked?  Yes  No
c) Refused insurance  Yes  No
d) DVLA notifiable medical condition.  Yes  No
e) Any non-motoring convictions.
 Yes  No
If answer to the any questions in section 3a is YES then enter details below  
Offence Date Conviction Date Conviction Code Fine Details
       
Accidents, loses or claims within last 5 years. If yes then please enter details below  Yes  No
F/NF Date Own Cost TP Cost Description
Vehicle Details
Make
Model
CC
Year
Seats
Value
Purchase Date
Registration
Parking
Overnight Parking
Paking Post Code
Is proposer the registered owner and keeper of the vehicle(s)  Yes  No
If not pleases give details:
Security Devices
Detail
Previous Insurance
Insurance
Policy No.
Expiry Date
NCB Years
NCB Type
   
Use Required
Private Hire (minicab)
Private Hire (Chauffeur)
Public Hire
   
Cover Required
Comprehensive
TPF & T
Third Party Only
   
Driving Options
Driving Opions
Mileage
Cover Required from
   
 
 
 
Flc Daily Insurance
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Flc Request A Quote
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Flc Commercial Insurance
FLC Insurance Services Ltd is one of
the leading company in UK. We are 
committed to provide our customers 
with best advice. We deal in 
Commercial insurance, personal 
insurance, property insurance and 
Vehicle insurance.
Flc Learner Driver Insurance
FLC Insurance Services Ltd is one of
the leading company in UK. We are 
committed to provide our customers 
with best advice. We deal in 
Commercial insurance, personal 
insurance, property insurance and 
Vehicle insurance.
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