Insurance Quote Request

INSURANCE QUOTE REQUEST

Please complete the inquiry form in order for Kuda to provide you with a Game or Livestock Insurance Quotation.

"*" indicates required fields

Client Type*

Company Name*

Company Registration Number*

Company VAT Number*

Client Name*

First Last

Client ID or Passport?*

Client ID Number*

Client Passport Number*

Client Street Address*

City*

Country*

Province/ State*

ZIP/ Postal Code*

Client Cell Number*

Client Email*

Auction Name*

Please tick 'YES' or 'NO' under 'Add to Quote' and select the 'Days Covered' from the lots below of which you would like to receive a quote on:

Lots Purchased on Auction*

Add to Quote

Days Covered

Lot Number

Lot Category

Quantity

Sum Insured (Vat excl.)

Stud Animal

Microchip Number

Breed

Gender

Date of Birth

Lastly, please complete the Risk Location fields below to identify where the lots/ animals will be kept:

Farm/ Risk Location Name*

District/ City*

Risk Country*

Risk Province/ State*

Risk ZIP/ Postal Code*

Notes (Optional)

Anything you would like to add that we should be aware of?

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