Telephone: 242-394-5555
P.O. Box SS 6283
Rosetta Street
Nassau, Bahamas
NEW PROVIDENCE
  PO Box SS-6283
  Rosetta Steet East,
 Palmdale, Nassau
  Tel: (242) 394-5555
 Fax: (242) 323-6520
Email: info.nassau@imbbah.com
GRAND BAHAMA
  PO Box F-42541,
  1 Pioneers Way,
 Freeport
  Tel: (242) 350-3500
 Fax: (242) 350-3510
Email: info.freeport@imbbah.com
ABACO
  PO Box AB-20666
  Queen Elizabeth Drive,
 Marsh Harbour
  Tel: (242) 367-4204
 Fax: (242) 367-4206
Email: info.abaco@imbbah.com
ELEUTHERA
  PO Box EL-25190
  Queen's Highway,
 Govemor's Harbour
  Tel: (242) 332-2862
 Fax: (242) 332-2863
Email: info.eleuthera@imbbah.com
EXUMA
  Queen's Highway,
  George Town,
  Tel: (242) 336-2304
 Fax: (242) 336-2305
Email: info.exuma@imbbah.com

PRIVATE CAR INSURANCE PROPOSAL FORM


Unless all material facts are disclosed, this insurance could be invalidated. Material facts are those facts an Insurer would regard as likely to influence the acceptance and/or assessment of the proposal. If you are in any doubt about whether facts are material, you should disclose them. A copy of the completed Proposal form will be supplied on request but you should keep a record (including copies of letters) of all information supplied to us for the purpose of entering into this contract. A specimen policy is available on request.

Please write in block capitals or tick the boxes as appropriate

Date insurance is to begin ( Which cannot be before the proposal is accepted by the insuers ) DD / MM / YY
Expiry Date DD / MM / YY

Proposer's Name:
Nationality:
Postal Address:
Email Address:
 
Occupation:
Employer:
Telephone:
(Home)
(Work)
(Cell)
 
Address at which car is normally kept:
House
Owned
Apartment
Rented
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Copyright 2009 Insurance Management (Bahamas) Ltd.