Insurance Quote

    The Insured's Details

    Your Name (required)

    Your Phone Number (required)

    Your Email (required)

    Your ABN (where applicable)

    Situation

    Occupation

    Due Date

    ___________________________________________________________________________________________________________________

    General Details

    Construction

    Walls:

    Floors:

    Roof:

    Number of Levels:

    Age:

    Fire Protection

    Security

    Alarm With:

    Name of Current Insurer

    Has Renewal Been Offered

    ____________________________________________________________________________________________________________________

    Claims History Last 5 Years

    Number and Incurred Costs

    Years in Business:

    Operators Industry Experience:

    Cooking facilities and Deep Fryers:

    Has the insured ever had any insurance declined or cancelled?
    YesNo

    Has the insured ever been charged with a criminal offence or declared bankrupt?
    YesNo

    Is the insured a property owner?
    YesNo

    ____________________________________________________________________________________________________________________

    Sum Insured Details

    Property

    Buildings:

    Contents (excluding stock):

    Stock:

    Cigarettes/Tobacco/Cigars:

    Liquor/Alcohol:

    Rent Payable:

    Removal of Debris:

    Accidental Damage:

    Business Interruptions

    Gross Profits:

    Claims Preparation Costs:

    Accounts Fees:

    Loss of Rent:

    Indemnity Period (years and months):

    Theft

    Stock (excluding tobacco):

    Tobacco/Cigarettes/Cigars:

    Contents and Stock:

    Alcohol/Liquor:

    Other:

    Money

    In Transit:

    On Premises (Bus. Hours):

    On Premises (After Hours):

    In Safe:

    At Private Residence:

    Damage To Safe:

    Type of Glass:

    Glass Internal:

    Glass external:

    Lightbox / Signs:

    Machinery and Plant

    Items:

    Deterioration of Frozen Food:

    General Property

    Description of Items:

    Cover For:
    Fire, TheftAccidental Damage

    Public and Products Liability

    Limit - Public Liabilty:

    Limit - Products Liabilty:

    Limit - Property Owners:

    Number of Permanent Staff:

    Number of Casual Staff:

    Turnover:

    Gross Wages Paid:

    Testing and delivery of vehicles limit:

    Goods in care custody and control:

    Additional Information: