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Renewal Declaration (Phone Only)
Do you require your insurance renewed?
Yes, I need to renew my insurance
No, I no longer require my insurance
Company or trading name
Do you still have the same ABN
Currently I have your occupation as (ADVISE CURRENT OCCUPATION) are you doing any additional work?
My business remain unchanged
My business has changed or is expected to change
Please explain the changes
Do you import or export?
What are you importing, where from and % of turnover derived from imports
Based on your occupation do you require any (list appropriate insurance products relevant to occupation) and assess the client, do they give advice if yes offer PI, do they have a premises, if yes offer business insurance, etc.
Estimated Turnover For The Next 12 Months
Please note an increased turnover will generally increase the premium.
Do you engage in any Subcontractors?
Yes, they have their own Public Liability Insurance
No, they do not have their own Public Liability Insurance
I do not engage sub-contractors
What do the sub-contractors do for the business?
Estimated Payments to Sub-Contractors For The Next 12 Months
Number of employees (including yourself)
Do you undertake any work on, or operate a business that is/has: Labour Hire, a refinery, chemical plant, petrol oil or gas production facilities or pipelines, offshore platforms, oil rigs, utilities, power station, silo's, water treatment plants, railways or railway infrastructure, airport, underground work, dams, above or below ground mine sites, trains, watercraft or any other marine or maritime exposure, aircraft, scaffolding, asbestos removal, pest control, nightclub, bar, pub, demolition, tree lopping, civil construction, cranes or work on lifts
I do not work on any of these
I do work on these
What of the above do you do?
In the last 5 years have you had any criminal convictions, been bankrupt, do you have any unreported claims or incidences that you may claim against, had any insurance declined or variations imposed or anything else that may affect your insurance that we should disclose to the underwriters?
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?
Home Loan Refinancing, let's see if we can get you a better deal
Truck and Commercial Vehicle Finance
Boat or Jet Ski Finance
Caravan, Camper, Motorhome or RV Finance
I Require Other Finance That Is Not Listed