Broker Application


COMPANY DETAILS

Company Name:
Address:
 
 
 
 
Town / City:
 
County:
 
 
Country:
 
Postcode:
Website:
 
 
Telephone Number:
 
Fax Number:
 

CONTACT DETAILS

Title:
 
Forenames:
Surname:
Contact phone number:
Alternative contact number:
Position:
Email address:

YOUR COMMENTS / CATEGORY REQUESTS

If you would like to provide further information or suggest alternative categories please do so in the comments box below:

Comments / Suggestions for new categories of insurance to be added to QuoteRack:
 

QUOTE REQUESTS

Please provide the email address that you would like all Quote Requests sent to below:

Quote Email address:

CATEGORY SELECTION

All currently available categories and the cost per quote request you receive (CPQ) for that category are listed below. If you don't see the category you require please let us know in the comments box provided.

Please select the categories that you specialise in from the list provided below by placing a tick in the appropriate boxes (This selection can be changed at a later date):


Business CPQ 
  • Architects insurance
    		•  £5.50
  • Arts and crafts insurance
    		•  £5.50
  • Blocks of flats insurance
    		•  £5.50
  • Business liability insurance
    		•  £5.50
  • Charity insurance
    		•  £5.50
  • Driving school insurance
    		•  £5.50
  • Entertainment insurance
    		•  £5.50
  • Event cancellation insurance
    		•  £5.50
  • Financial advisors
    		•  £5.50
  • Firework display insurance
    		•  £5.50
  • General tradesmen insurance
    		•  £5.50
  • Hazardous materials business insurance
    		•  £5.50
  • HGV and hauliers insurance
    		•  £5.50
  • Hotel, B&B and guest house insurance
    		•  £5.50
  • Insurance brokers
    		•  £5.50
  • Landlords insurance (multiple properties)
    		•  £5.50
  • Leisure industry
    		•  £5.50
  • Licensed trade - pubs, bars and off-licences
    		•  £5.50
  • Manufacturing insurance
    		•  £5.50
  • Marine, freight and cargo insurance
    		•  £5.50
  • Motor fleet insurance
    		•  £10.00
  • Motor trade - road risks
    		•  £5.50
  • Motor trade - with commercial premises
    		•  £22.00
  • Multiple events insurance (Annual Policy)
    		•  £5.50
  • Music event liability insurance
    		•  £5.50
  • Musicians insurance
    		•  £5.50
  • Nightclubs, casinos and adult clubs
    		•  £5.50
  • Office contents insurance
    		•  £5.50
  • One-off event or show insurance
    		•  £5.50
  • Performing artists
    		•  £5.50
  • Professional indemnity insurance
    		•  £5.50
  • Restaurants and takeaways insurance
    		•  £5.50
  • Security companies
    		•  £5.50
  • Shop insurance
    		•  £5.50
  • Solicitors' insurance
    		•  £5.50
  • Stockbrokers and investment managers insurance
    		•  £5.50
  • Van couriers insurance
    		•  £8.00
  • Wedding insurance
    		•  £5.50
  • Wholesaling business insurance
    		•  £5.50

    Car CPQ 
  • 4x4 car insurance
    		•  £2.50
  • Agreed value car insurance
    		•  £2.50
  • American car insurance
    		•  £2.50
  • Car Insurance – standard risk vehicle / drivers
    		•  £2.50
  • Chauffeur hire insurance
    		•  £3.25
  • Classic car insurance
    		•  £2.50
  • Company-owned car insurance
    		•  £3.50
  • Disabled drivers' car insurance
    		•  £2.50
  • Drivers with accidents or convictions
    		•  £2.50
  • Driving instructor insurance
    		•  £3.25
  • Female driver car insurance
    		•  £2.50
  • Fleet motor insurance
    		•  £10.00
  • Grey import car insurance
    		•  £2.50