Somerville National Leasing & Rentals Ltd.
RAPIDQUOTE REQUEST FORM
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CUSTOMER INFORMATION
Name _______________________________________________________________
Company ____________________________________________________________
Business Phone (_______)_______-___________
Business Fax (_______)_______-___________
Residence Phone (_______)_______-___________
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URGENT [ ]
Required within 4 hours
SOON [ ]
Required within 48 hours
FUTURE [ ]
Required within 7 days
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VEHICLE INFORMATION
Year ______ Make ________________ Model _________________________
Transmission
[ ] Automatic [ ] Standard [ ] 4 Wheel Drive
Engine Cylinders
[ ] 4 [ ] 6 [ ] 8
Body
[ ] 2 Door [ ] 4 Door [ ] Wagon [ ] Van
Lease Term
[ ] 24 months [ ] 36 months [ ] 48 months
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PLEASE INCLUDE
[ ] Insurance [ ] Extended Warranty
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OPTIONS
[ ] Air Conditioning [ ] Cruise Control
[ ] Tilt Steering [ ] Power Windows
[ ] Power Locks [ ] Power Seats
[ ] ABS Brakes [ ] AM/FM Stereo
[ ] Cassette [ ] CD Player
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Please complete the RapidQuote form and fax it to Somerville. You will be contacted within the time frame you have chosen.
Toronto West Toronto East Calgary
Phone (416) 252-6956 Phone (416) 752-6262 Phone (403) 777-1460
Fax (416) 252-6507 Fax (416) 752-6268 Fax (403) 777-1464