Request - Bicycle Insurance Safebike - Equinox

REQUIRED CONDITION FOR OBTAINING : 2 ART LOCKS**

Bicycle insurance *

Safebike Registration

Type of insurance requested *

Bicycle purchased at

First Name & Last Name *

Insured as a company

Phone number

Your email address *

Postal address *

Marque du vélo *

Type of bike *

Model of bike *

Insured Amount *

Frame Number *

Battery Number *

No. lock ART2 - 1 *

No. lock ART2 - 2 *

Invoice(s) of purchase *

A copy of this form will be sent to you by email *

Separate email addresses with a comma.

Submit the request to EQUINOX

Your insurance request has been sent