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City Rural Insurance Brokers in Adelaide South Australia

City Rural Insurance Brokers in Adelaide South Australia, was established in July 1995 and over this time has developed specialist brokers in areas ranging from Commercial Motor, Market Stalls, Professional Indemnity, Liability, Business and Arts and Crafts Insurances for clients across Australia.

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Motor Vehicle Quote

Step 1 of 5 - Personal information

20%

Hi, let's get some details for your vehicle quote.
Registered Owner Name*
First Last
Address*
Street Address City State Post Code
Email*
Phone No*
Currently insured?*
- Yes
- No
Expiry date

Day
Month
Year

Tell us about Vehicle details.
Vehicle Year/Make/Model*
Petrol or Diesel*
Body type*
Transmission*
Rego Number*
Purchase Price
Purchase Date

Day
Month
Year
Engine Size
VIN Number
Security Device Fitted?*
- Yes
- No
if yes, is it an immobiliser, alarm, tracking system, etc?
Vehicle Roadworthy & Registered*
- Yes
- No
If no, please note further details

Tell us more details about your vehicle.
Use of Vehicle*
Occupation*
Address where vehicle is left overnight
Street Address
Parked overnight in*
If Other*
Finance*
- Yes
- No
Financier*
Accessories
Accessories value
Modifications
Modifications value
Colour of vehicle*
Approx number of kilometres driven per year*

Tell us about the drivers claims history
No Claim Bonus or Rating No*
Subject to written proof
Drivers Details*
Name Date of Birth (dd/mm/yyy) Years driving Occupation

Please ensure % of Use totals to 100% across all drivers.
Have any of the above drivers ever had:
Accidents or claims*
- Yes
- No
Traffic offences (excluding parking)*
- Yes
- No
Licence cancelled/ endorsed/ suspended*
- Yes
- No
Criminal convictions*
- Yes
- No
Bankruptcy*
- Yes
- No
If yes, to any of the above please give full details
eg date, description, insurer, and value of claim
Number of demerit points lost in the last 5 years**

Additional options
Windscreen protection*
- Yes
- No
Hire car after an accident*
- Yes
- No
Type of Cover Requested*
- Comprehensive
- Third Party Fire & Theft
- Third Party Property Damage
Additional notes
Thanks for your details, please confirm you are not a robot and we'll get onto your quote request straight away. We'll make contacts directly to you via email.
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CITY RURAL INSURANCE BROKERS PTY LTD

Australian Financial Services Licence No 237491
ABN: 52 074 444 296

Name	Date of Birth (dd/mm/yyy)	Years driving	Occupation

Step 1 of 5 - Personal information

Hi, let's get some details for your vehicle quote.

Tell us about Vehicle details.

Tell us more details about your vehicle.

Tell us about the drivers claims history

Have any of the above drivers ever had:

Additional options