Motor Car Quotation Portal
Client Details
Name:
Address:
Mobile Number:
Motor Vehicle Details
Make / Brand:
Year Model:
Plate Number:
Vehicle Type:
1
COMMERCIAL VEHICLE (CV)
1.2
Jeepney
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1.3
Wagon
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1.4
Pick Up
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1.5
Van
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1.6
Aluminum Van
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1.7
FB Type
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1.8
WING VAN 4 Wheeler (4W)
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1.9
WING VAN 6 Wheeler (6W)
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1.10
WING VAN 8 Wheeler (8W)
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1.11
WING VAN 10 Wheeler (10W)
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1.12
ELF 4 Wheeler (4W)
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1.13
ELF 6 Wheeler (6W)
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1.14
ELF 8 Wheeler (8W)
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1.15
ELF 10 Wheeler (10W & UP)
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1.16
Canter 4 Wheeler (4W)
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1.17
Canter 6 Wheeler (6W)
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1.18
Canter 8 Wheeler (8W)
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1.19
Canter 10 Wheeler (10W & UP)
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1.20
TRUCK 4 Wheeler (4W)
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1.21
TRUCK 6 Wheeler (6W)
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1.22
TRUCK 8 Wheeler (8W)
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1.23
TRUCK 10 Wheeler (10W & UP)
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1.24
Tractor Head
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1.25
Trailer
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2
LAND TRANSPORTATION OPERATOR (LTO)
2.1
Public Utility Bus (PUB)
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2.2
Tourist Bus (TB)
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2.3
School Bus
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2.4
School Service
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2.5
Public Utility Jeepney (PUJ)
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2.6
Garage / Shuttle Service
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2.6.1
Van
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2.6.2
AUV/SUV
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2.6.3
Wagon
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2.6.4
UV Express
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2.7
TAXI
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2.8
Tourist Cars
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2.9
Tricycles
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3
MOTORCYCLE (MC)
3.1
Motorcyle (Single)
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3.2
Motorcyle with Side Car
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4
PRIVATE CAR (PC)
4.1
Sedan
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4.2
Jeepney
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4.3
Wagon
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4.4
Pick Up
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4.5
Van
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Annual Premium
Fair Market Value:
Act of Nature:
Bodily Injury Premium:
Property Damage Premium:
L/D Premium:
Total Premium:
VAT:
DST:
LGT:
Total Amount Due: