Online Quote Request
  Please click on each heading in the grey boxes below to complete further information, then click submit quote. Remember the more information we receive from you, the more accurate our quotation will be.

One of our qualified specialists will contact you during business hours.
 
  New Business
  Renewal
  Trading Name*
  *Contact Name
  Phone*
  Email*
  Address
  State
  Postcode
PROPERTY DETAILS
Building Use
if other specify:
Is operator licensed



Are premises licensed/approved



Do premises comply with council regulations



Age of building





Purpose built building



Heritage listed



Condition of building




Type of tenancy



Nearest neighbours
Occupation of neighbour
CONSTRUCTION
Walls
Roof
Ground Floors
Upper Floors ( if applicable)
Frame
FIRE PROTECTION
Protection Type None
Fully sprinklered
Part sprinklered(min 50%)
 
EXTINGUISHERS
No of Dry Chemical
No of BCF
No fo CO2
No of Water type
No of Foam
Maintenance contract yes
no
No of extinguishers per floor
Date of Last Service
FIRE ALARMS
Alarm Type
Hard wired detector in each room yes
no
Detection Type Thermal
Smoke
Do higher than normal exposures exist in respect of:
   
ACCOMMODATION
Number of accommodation rooms
Number of beds per room
Proportion of rooms tenanted by permanent residents
Is smoking permitted in common rooms yes
no
Is smoking permitted in accommodation rooms yes
no
KITCHEN FACILITIES
Is cooking allowed in rooms yes
no
What kitchen facilities are in rooms
Are guest kitchens provided yes
no
Number and location
List kitchen/facilities/equipment
Protection within kitchen
Is there any deep frying yes
no
Who cleans ducts and flues Self
Contractor
How often are they cleaned Weekly
Fortnightly
Monthly
ELECTRICAL
  Fuses
Circuit breakers
Age of Installation New
Modern
Old
Date of last electrical inspection
Are extension cords used yes
no
SECURITY
External doors
External windows Bars/grilles
Key Locks
Burglar alarms
Other security
Safe
Make of safe
Torch/drill resistant yes
no
FIRE ESCAPES
For buildings other than single storey is there an external fire escape from each above ground floor yes
no
What is the construction of external fire stairs
Does each exit have an illuminated EXIT sign yes
no
Are emergency escape procedures posted in all sleeping rooms yes
no
Are emergency escape procedures posted in all common areas yes
no
Are there self closing fire rated doors yes
no
Are there internal fire escapes yes
no
Construction of internal fire escpaes
If other please specify
PUBLIC LIABILITY
 
Total annual turnover
Turnover accommodation
Turnover bottle shop
Turnover Bar
Turnover NET gaming
Any other source
SECTIONS INSURED
Fire & Perils - Property
Buildings
All contents (excl stock)
Stock
Managers contents
Removal of debris
Accidental damage
Total
Business Interruption
Gross profit
Wages(if required)
Additional increased
Rent Payable
Auditors & accountants fees
Total
Burglary
Stock (excl tobacco & cigarettes)
Other contents
Damage to premises
Total
Money
In transit
In building - business hours
In building-non business hours
In safe
In ATM
In gaming machines
Your employees residence
Damage to safe
Total
If you require quotes on the following please contact us for more information
  Machinery breakdown
Tax audit
Fidelity
Glass
Other
INSURED'S HISTORY
Important: Ensure all relevant details are disclosed.  Any wrong answers you provide may affect your future claims
How many years has the insured operated this business
How many years previous industry experience
Have you ever had any food or health violations against you yes
no
Have you or any persons connected with this insurance ever had a revoked license yes
no
Been declared bankrupt or had legal proceedings lodged against you yes
no
Had an insurer that has declined to insure you yes
no
Had an insurer that has declined to renew your insurance yes
no
Hand an insurer that has imposed special conditions on your insurance yes
no
Have you within the last five (5) years, suffered a claim that would have been covered by this insurance and or claimed for any loss or damage or received any demand or writ for personal injury or damage to property yes
no
After enquiry are you or any director or employees aware of or have any grounds for suspecting any circumstances which might give rise to a claim, against your or against any of the present or former directors during the last five (5) years yes
no
Please provide full details, if any answers to the above questions are “yes”. With any previous claims, please detail amount paid or reserved the year and your excess at the time, and background information on the claim
* I have read and understood the Duty of Disclosure and Privacy Policy
 


Duty of Disclosure and Privacy Policy

 

 

Your Duty of Disclosure

Before you enter into an insurance policy, it is your duty to disclose every matter that you know, or could be reasonably expected to know, to be relevant to the insurance company’s decision whether to give you insurance cover and, if so, on what terms. Consequences of non-disclosure or misrepresentation – If you breach your duty of disclosure; the insurer(s) may be able to refuse to pay a claim or to cancel your policy.  The same applies where you have made a misrepresentation, if fraudulent (ie. done deliberately for the purpose of obtaining insurance or for obtaining it on favourable terms) the insurance company may be able to ‘avoid’ your policy.  This means that the insurance company can treat the policy as never having existed.  Non-disclosure or misrepresentation in relation to one policy may affect your ability to obtain other insurance in the future.  If you are unsure whether some information may be disclosable or not we suggest you call your insurance broker and seek guidance. 

Privacy

We are committed to protecting your privacy.  We only use the personal information you provide to us to quote on and insure the risk.  We only provide your personal information to your insurer(s) and reinsurers (and their representatives) and those we appoint to assist us with claims under your policy (ies).  We do not trade, rent or sell information.  Some or all of the insurer(s) and reinsurers may be overseas.  If you don’t provide us with complete information, we cannot properly quote for your insurance and we cannot insure you.  You can check the information we hold about you at any time. For more information about our Privacy Policy, ask us for a copy.  Copies of the proposal form should be retained for your own records.

Risk Survey

Acceptance of the proposal risk may be subject to a survey to be carried out by or on behalf of the underwriters.  In the event that the survey results in findings of misrepresentation underwriters may be able to decline any potential claim.  Please note that by carrying out a site survey and report any ensuing requirements and/or recommendations shall not constitute any undertakings on the part of the underwriters or others to determine of warrant that the premises surveyed are safe, fit or compliant with any Federal, State, Local Government law, statute, by-law, rule, regulation, building code or the like.

  

 
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