Benefits

This section will provide a one-off payment to cover claims notified to the company during the period of insurance which are the sole cause of or reduction in:

a) No Claims Bonus - Maximum payment £250
b) Payment of excess contribution - Maximum payment £150
c) or both a) and b) - Maximum payment £400

Basis of Cover

Number of Employees:

Number of Volunteers:

I/We declare that

• We will maintain an accurate register of participating employees and volunteers which will be available for inspection if required.
  
• All employees/volunteers will be advised to contact their own vehicle insurers to advise them of the use to which the vehicle will be put.
  
• Only those individuals whose names appear on the register will benefit from the cover.
  
• At Renewal of the policy, a copy of the register for the previous year will be supplied to Keegan & Pennykid (Insurance Brokers) Ltd.
  
• All claims forms will be completed by the claimant and countersigned by a competent officer on behalf of the organisation.

Name of Director/Trustee/Office Bearer who is submitting this form:

This Summary of Cover is designed as a guide only to the cover provided. Full details can be obtained from Keegan and Pennykid (Insurance Brokers) Ltd.

Please check the wording of this Proposal and the data you have entered carefully before proceeding by clicking on the 'continue to next stage: final check' button, below. Clicking on the button will not submit your details yet, but will cause another page to load.

The new page that loads will give you a chance to check your data again, and if you need it you will get another opportunity to make changes before finally sending the data.

If you notice an error shortly after sending the data (when you see the page that invites you to print the submitted data out for your records) you can resubmit a corrected version. After submitting, you can try using your browser's Back button to return to the form. If you are lucky, the data might still be displayed, which would save you typing it all in again.

If you resubmit in this way, please also indicate this here:

If you only notice an error later and it's too late to go back and resubmit, or you find that the data has disappeared from the form when you return to it, please make a copy of your printed record and fax it to us along with an indication of the change(s) you wish to make.

Alternatively, please call us on (0131) 225 6005 and explain the change(s) you would like us to make for you.

Please note that in such circumstances we may have to send you a form to fill in on paper and sign in order to confirm changes.