Any advice that may have been given is general advice only, please be aware that we have not taken into consideration your needs, objectives or financial requirements. Before deciding to purchase a financial product you should consider the appropriate Product Disclosure Statement to ensure the product is suitable for your needs.

Business Details

Company or Business Name * 🛈

ABN

Business Activity (Occupation) * 🛈

Please explain your business activities * 🛈

Postcode *

Number of Staff *

Estimated Annual Turnover *

Cover Required

Save time Upload your Current Business Insurance Policy Schedule. 🛈

If Yes Please provide detail:

Public and Products Liability

Public and Products Liability 🛈

Yes

Public Liability

Estimated Amount Paid to Sub-Contractors

General Property

General Property 🛈

Yes

General Property Sum Insured 🛈

Glass Cover

Glass 🛈

Yes

Glass Cover Required 🛈

Machinery Breakdown

Machinery Breakdown 🛈

Yes

Blanket Plant and Machinery Details - Enter Number of Units 🛈

Limit any one loss

Machinery Sum Insured

Business Property

Business Property 🛈

Yes

Theft 🛈

Yes

Insurance Required Building

Insurance Required Stock & Content

Insurance Required Content (Excl Stock)

Insurance Required Burglary Theft Stock or Content

Tobacco Cigarettes Alcohol

Street

City

Age of Building

Building Stories

Walls

Roof

Floor

Alarm

Deadlock

Window Secruity

Please select the monitored base alarm type

Class 2 e.g Digital Dialler

Class 2 e.g Digital Dialler + GSM Cellular phone back-up polled daily

Class 3 e.g Multi-path GPRS polled < 120 Sec

Class 4 + 5 e.g. Direct Line or Multi-path Ethernet/GPRS polled < 60 Sec

Additional Security

Fire Prevention Details

Do you require Flood Cover?

How much Expanded Polystyrene (EPS) does the premises contain? (i.e Cool Rooms)

Electronic equipment

Electronic Equipment 🛈

Yes

Electronic Equipment - Please include value 🛈

Good in Transit

Goods In Transit 🛈

Yes

Temperature Control Goods

Annual Sendings

Money Cover

Money 🛈

Yes

Money Cover Sum Insured

Money Cover Required

Business Interruption

Business Interruption 🛈

Yes

Business Interruption Cover 🛈

Contacting you about your quote:

First Name

Last Name *

Email *

Phone *

Additional Information

Declaration: I/WE HEREBY DECLARE AND WARRANT that the answers given above are in every respect true and correct, and that I/We have not withheld any information within My/Our knowledge likely to affect the decision of the Company as to My/Our eligibility for insurance. This request and declaration shall be the basis of the quote request. *

Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Ever been declared bankrupt?
Ever been involved in a company or business which became insolvent or subject to any form of insolvency or voluntary administration (e.g. liquidation or receivership)?
Ever been convicted of any criminal offence (other than minor traffic convictions)?
Made any insurance claims in the last 5 years? *

Bollards in front of property	CCTV System Installed
External Lighting	Electronic keypad/swipe card access
Protection of Display Windows	Roller Shutters
Security Fencing	Security Patrols

Fire Protection Single Sprinklers	Fire Protection Dual Sprinklers
Fire Protection Hydrant Hoses	Fire Protection Extinguishers
Smoke Detectors Local	Smoke Detectors Monitored