Business Insurance

Advice Line 1300 464 989

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Business Insurance

Advice Line 1300 464 989

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2
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6

Business Information

Occupation

Change

Number of Employees (including you)

Annual Income

$

Please provide an approximate % breakdown of Annual Income by State or Territory according to where it is earned:

Total must be 100%:

NSW

ACT

QLD

VIC

TAS

SA

WA

NT

Overseas

Are you a small business eligible for exemption from paying NSW stamp duty on certain types of Insurance?

Yes No

Yes

No

Do you require Building and/or Contents Insurance?
(The policy covers business property only)

Location 1

Do you Own the Premises?

Yes No

Are you the Only Tenant?

Yes No

Please provide Names of Tenants and Industry they operate in

Is the Building Heritage Listed?

Yes No

Facade Only Whole Building

Street Number/Name:

Suburb:

Postcode:

State:

What year was the Building Constructed?

Has the Premises been re-wired and re-plumbed?

Yes No

Building Construction:

Non-combustible Combustible

Building Replacement Value:

$

Contents Replacement Value:

$

Are Deadlocks fitted on all External Doors?

Yes No

Do you use swipe cards to access the premises?

Yes No

Does your premises contain more than 15% Expanded Polystyrene (EPS)?

Yes No

Location 2

Do you Own the Premises?

Yes No

Are you the Only Tenant?

Yes No

Please provide Names of Tenants and Industry they operate in

Is the Building Heritage Listed?

Yes No

Facade Only Whole Building

Street Number/Name:

Suburb:

Postcode:

State:

What year was the Building Constructed?

Has the Premises been re-wired and re-plumbed?

Yes No

Building Construction:

Non-combustible Combustible

Building Replacement Value:

$

Contents Replacement Value:

$

Are Deadlocks fitted on all External Doors?

Yes No

Do you use swipe cards to access the premises?

Yes No

Does your premises contain more than 15% Expanded Polystyrene (EPS)?

Yes No

Location 3

Do you Own the Premises?

Yes No

Are you the Only Tenant?

Yes No

Please provide Names of Tenants and Industry they operate in

Is the Building Heritage Listed?

Yes No

Facade Only Whole Building

Street Number/Name:

Suburb:

Postcode:

State:

What year was the Building Constructed?

Has the Premises been re-wired and re-plumbed?

Yes No

Building Construction:

Non-combustible Combustible

Building Replacement Value:

$

Contents Replacement Value:

$

Are Deadlocks fitted on all External Doors?

Yes No

Do you use swipe cards to access the premises?

Yes No

Does your premises contain more than 15% Expanded Polystyrene (EPS)?

Yes No

Location 4

Do you Own the Premises?

Yes No

Are you the Only Tenant?

Yes No

Please provide Names of Tenants and Industry they operate in

Is the Building Heritage Listed?

Yes No

Facade Only Whole Building

Street Number/Name:

Suburb:

Postcode:

State:

What year was the Building Constructed?

Has the Premises been re-wired and re-plumbed?

Yes No

Building Construction:

Non-combustible Combustible

Building Replacement Value:

$

Contents Replacement Value:

$

Are Deadlocks fitted on all External Doors?

Yes No

Do you use swipe cards to access the premises?

Yes No

Does your premises contain more than 15% Expanded Polystyrene (EPS)?

Yes No

Location 5

Do you Own the Premises?

Yes No

Are you the Only Tenant?

Yes No

Please provide Names of Tenants and Industry they operate in

Is the Building Heritage Listed?

Yes No

Facade Only Whole Building

Street Number/Name:

Suburb:

Postcode:

State:

What year was the Building Constructed?

Has the Premises been re-wired and re-plumbed?

Yes No

Building Construction:

Non-combustible Combustible

Building Replacement Value:

$

Contents Replacement Value:

$

Are Deadlocks fitted on all External Doors?

Yes No

Do you use swipe cards to access the premises?

Yes No

Does your premises contain more than 15% Expanded Polystyrene (EPS)?

Yes No

Promotional Code (if relevant)