Online Enquiry Form


	LAKESURE Limited Online Enquiry Form Please complete all the details


The more details that you fill in for us, the quicker we can get a quote back over to you.			Please type your details in upper & lower case.
Your name
Establishment name
Address
Address 2
Post code
Telephone
Fax
email
Any claims in the last 5 years? Add details
Renewal Date DD/MM/YYYY
Buildings Sum Insured
Contents Sum Insured
Turnover
If you are having any difficulty filling out this form call our UK helpline during office hours Monday-Friday Tel 01702 471135 (Brian or Sarah) Fax 01702 471185
Or alternatively email us quotesonline@lakesure-insurance.co.uk

LAKESURE Limited