Lloyd Manley Associates - Cargo Enquiries

Please complete the following Cargo Enquiry form

General:
Company Name:
Address 1:
Address 2:
Post Code:
Telephone:
E-mail:
Business description:
Type of Firm:
	Limited Company
	Partnership
	Sole Trader
When established:
Annual Turnover:	£
Have you had any claims in the last 5 years:	Yes No
If Yes, please give details:
Goods or Products:
Please describe type of goods you require insurance for and how they are packed
Maximum Sum Insured each shipment/consignment	£
Are goods carried in full container loads only?	Yes No
Basis of valuation	CIF + 10% Exports Yes No
	Ex Works Imports Yes No
Estimated Value of Annual Shipments to or from -
Europe	£
North America	£
South America	£
Africa	£
Middle East	£
Asia/Far East	£
Australasia	£
Do you issue certificates of insurance?	Yes No
Please advise special conditions of cover required
Percentage of Goods by Road and Sea	%
Percentage of Goods by Road and Air	%
Percentage of Goods by Road only	%
Your name:	Position:

Authorised and Regulated by the Financial Services Authority for General Insurance Business No. 302600