Commercial Property Quote Form

1Personal Information

2Building Information

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Lead Source
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Lead Type
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Lead Status
Full Name*
First Last
Email Address*
Phone Number*
Age of Oldest Insured*
Occupancy Type*
You or your tennants occupation/s or add in your website if you are a shopping centre*
Building type*

Construction Details
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Walls*
Roof*
Year built*
Number of levels*
Does the premises have any construction using (EPS) Expanded Polystyrene? Panels commonly used for cool room walls and roofs*
What percentage of your Building/floor space is made up of Expanded Polystyrene? (EPS)
Please enter a number from 0 to 100.
Building and Business Insurances
Building replacement value $
Contents Replacement Value (excluding Stock)*
Burglary or Theft Stock*
Burglary or Theft Tobacco or Alcohol
Do you need Business Interuption Insurance? (keeps income coming in, such as waiting for your property to be rebuilt after a fire)*
Machinery Breakdown*
How Many Machinery Units Do You Want To Cover?*
Deterioration Of Stock
Plate Glass Insurance*
Do you need cover for loss of rent?*
What is your annual rental income?*
We offer finance broking as one of our services. Do you require pricing on any loans or finance?*
What type of finance do you require?*
Other Insurances*
- Management Liability (highly recommended)
- Cyber Liability
- Electronic Equipment Breakdown
- Tools/ General Property Cover
- Transit Cover
- Commercial Motor
- None are Required
Additional information

Construction Details