Tel :
011 282 3400
Fax :
011 783 1026
Email :
info@gagecarhire.co.za
Claims Handler
Date
Authorised by
Telephone Number
Email
Insurer Details
Insurer
Claim Number
Insured Name
Driver
Contact Number
Type of Incident
Accident
Mechanical Breakdown
Service
Theft
Write-off
Rental Details
Car Group
T - Small Hatch
B - Manual Hatch
C - Manual Sedan
D - Auto Sedan
E – 8 Seater Kombi
F - Toyota Corolla or Similar (Automatic)
H – Audi A3
O – Mercedes C180
S - Renault Duster Manual
V - Toyota Avanza (similar)
W - Toyota Hilux (similar)
Y - 1 Ton LDV Open or Closed
Z - 10 Seater Kombi
Date Hired From
Total Days Required
Max. Days Allowed
Remarks
Panelbeater
Panelbeater Name
Panelbeater Contact Number
Quotation Number
Damaged Vehicle Reg Number
All Rights Reserved. Gage Car Hire
1st Floor Tropicana House, 1 Palmboom Place Athol Ext 12 Sandton P.O. Box 787, Strathavon, 2031