Machinery Breakdown LOP Quotation

First Name / Corporate Name

Last Name

Mobile No.

Email Address

Which branch do you want to be served from?

Note: Machinery Breakdown Policy is a pre-requisite for Machinery Breakdown – LOP policy.

Insurance Start Date

Insurance End Date

Gross Profits

Indemnity period(In months)

Note: Gross Profits = Operating Profits + standing charges for 12 successive months of business