Commercial Products Fact Find - Rysk

  • Commercial Products Fact Find

  • Select Risk Classes
    • Liabilities 

    • Liabilities

      General Cover

    • General Liability

    • Does any of your work involve the use of naked flames or open heat sources including cutting, welding or grinding?

    • Hot Work

    • Hazardous Substances

    • Do you use, store, handle, manufacture or transport any acids, chemicals, gases, inflammables, explosive, toxic or hazardous substances or materials?
    • Material Details?
    • Are hazardous goods used, stored or transported in accordance with the applicable laws?

    • Product Details

    • Have you withdrawn or recalled any products?
    • Is your business now or in the past been involved in the manufacture, distribution or sale of the following goods?
    • In relation to products, do you carry out work overseas or export any products you manufacture, sell, handle, supply or distribute?

    • Coverages

    • Optional Extensions

    • Property Being Worked On/Defective Workmanship
    • Statutory Liability 

    • Statutory Liability

    • Retroactive Type
    • Retroactive Date
       - -
    • Employers Liability 

    • Employers Liability

    • Retroactive Type
    • Retroactive Date
       - -
    • Management Liability 

    • Management Liability

    • Date Business Started Trading
       - -

    • Business Details

      How many people do you employ in New Zealand?

    • Locations

      Please advise where your business is conducted, your activities at each location and whether premises are owned or leased.
    • Do you have any locations or contracts to work outside of New Zealand?
    • Is the business currently able to meet its debts as they fall due?
    • Do you require the Insolvency Exclusion to be removed?

    • Product Details

      Note: Insured’s products means any goods – including labels, instructions for use, advice and property – after they have ceased to be in the possession of or under the control of the insured, manufactured, constructed, erected, installed, repaired, serviced, treated, sold, supplied or distributed by the insured (including any container, other than a vehicle).
    • Do you manufacture the products you sell?

    • Please advise what products you design and whether they are to your own, or your customers’, specifications.

    • Are any of your products used as components of, or incorporated or mixed into, any other products produced by any other parties?
    • Do you sell products in New Zealand?

    • Please provide details of all products sold in New Zealand

    • Do you export products

    • Please provide details of all work you undertake away from your premises and the percentage of turnover this generates.

    • Do you service or repair any third-party property?
    • Do you have third-party property in your care, custody or control?
    • Does any of your work involve cutting, welding, or the use of naked flames or open heat sources?
    • Do you use, store, handle, manufacture or transport any acids, bulk liquids, chemicals, explosives, gases or any flammable, hazardous or toxic goods or substances?
    • Do you provide professional, technical or consultancy services or advice to your customers?
    • Do you charge a fee for these professional services
    • Professional Indemnity 

    • Professional Indemnity

    • Retroactive Professional Indemnity Date
       - -

    • Personnel by category

    • Rows

    • Business Details

    • Categorise your business activities applicable to the above in relation to the ‘Professional’ Services and provide the percentage of your total gross income in fees obtained for your last financial year by those categories.
    • Do you have contracts to work outside New Zealand?
    • Has the business name ever changed?
    • Have you ever acquired another business or merged with another business?

    • Financial Information

      Please provide total gross fee or income for last financial year (actual), current financial year (projected), and next financial year (estimate)
    • Rows

    • Principals, Partners and Directors

      Please provide details in respect of all current principals, partners and directors
    • Date Qualified
       - -
    • Date Qualified
       - -
    • Date Qualified
       - -
    • Date Qualified
       - -
    • Are any of the principals, partners or directors financially or otherwise associated with any other business?

    • Professional bodies

    • Other Details

    • Do you undertake any work which would involve you in manufacturing, construction, erection or installation?

    • Supply Details

    • Do you undertake any work which would involve you in the supply of materials, plant, goods, or equipment?
    • Does the supply relate to branded products only?
    • Do the products originate from suppliers outside New Zealand?

    • Large Contractual Agreements

      Please provide details of the businesses five largest contracts undertaken during the last five years
    • Does any one client account for more than 50% of the business annual income?

    • Written Reports

    • Does the business provide written reports to clients?
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    • Are verbal reports always confirmed in writing?

    • Consultant, Subcontractor, Agent Details

    • Do you engage consultants, subcontractors or agents?
    • Do you insist they carry their own Professional Indemnity Insurance?
    • Do you enter into any hold harmless agreements or otherwise waive any legal rights or entitlements which you may have against such consultants, subcontractors or agents?
    • Do you use a standard contractual agreement when engaging independent consultants or contractors?
    • Do you use a standard contractual agreement for the supply of your professional services?

    • Prior Insurance History

    • Has the business or any principal, partner or director ever been refused insurance of the type proposed, had a similar policy cancelled or had special terms imposed?
    • Has the business, any partner, principal, director or staff member ever been the subject of disciplinary proceedings for professional misconduct?
    • Has any claim(s) ever been made against the business, its predecessors, or against any present or past principals, partners or directors?
    • Date of claim 1 or loss 1
       - -
    • Is the matter finalised or outstanding?
    • Date of claim 2 or loss 2
       - -
    • Is the matter finalised or outstanding?
    • Date of claim 3 or loss 3
       - -
    • Is the matter finalised or outstanding?
    • Date of claim 4 or loss 4
       - -
    • Is the matter finalised or outstanding?
    • Date of claim 5 or loss 5
       - -
    • Is the matter finalised or outstanding?

    • Potential Claims

    • Are any of the principals, partners or directors aware, after enquiry of all staff, managers and contractors, of any facts or circumstances which may give rise to a claim or claims of the type insured by this policy?
    • Rows
    • Are any of the principals, partners or directors aware, after enquiry of all staff, managers and contractors, of any accounts overdue for payment where there is reason to believe that the client is dissatisfied with the professional services rendered?
    • Have you ever withdrawn a claim?
    • Cyber Liability 

    • Cyber Liability

    • Risk Management

    • Is all personally identifiable and confidential information that is removed from your premises in any electronic format encrypted? (e.g. USB, flash memory, disk hard drive, tape or other means?)
    • Do you regularly update (at least monthly) firewalls and virus protection software in place within your networks?
    • Do you have a Business Continuity Plan (BCP) which includes back-ups stored off-site, in place that is tested at least annually?
    • Do you have procedures for verifying destination bank accounts and/or any changes to destination bank account details, before funds are transferred?
    • Do you hold an approved list of vendors and suppliers, including authorised contact people and contact details, which is checked when payments are made?

    • Vendor Management

      Please identify your critical vendors (Type of Vendor):
    • Cloud / Back-up / Web Hosting
    • Internet Service Provider (ISP)
    • Business Critical Software Provider
    • Data Processors (e.g. payment processing)
    • POS Hardware Provider
    • Managed Security Services (e.g. firewall, intrusion detection, anti-virus)

    • Claims and Circumstances

      Please answer the following questions after enquiry within your organisation.
    • During the past 5 years has any claim been made, or have any circumstances which may give rise to a claim, against any entity or individual to be insured by this insurance been notified to insurers?
    • Are there any circumstances not already notified to insurers which may give rise to a claim against any entity or individual to be insured by this insurance?
    • Has any principal or staff member ever been subject to disciplinary proceedings, regulatory action, or investigation by any Government, regulatory or administrative agency?
    • Material Damage 

    • Material Damage

      All locations
    • Natural Disaster Cover Required
    • Stock/Other Property Anywhere in New Zealand
    • If the FEL is calculated on the indemnity value of the insured property and not the sum insured and a valuation of less than 2 years old has not been provided, has a declaration as prescribed by the Fire and Emergency Act been received for the current policy period?

    • Location One

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Buildings Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Location Two

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Buildings Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Location Three

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Buildings Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Location Four

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Buildings Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Location Five

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Buildings Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Location Six

    • Date of last valuation (Building)
       - -
    • Date of last valuation (Plant)
       - -
    • Does the building contain sandwich panels e.g Chiller units, spray booths
    • Fire Detection System
    • Date of last certification
       - -
    • Towns/Main Water Supply
    • Is 50% of more of the building floor area unoccupied?
    • Are there any interested parties to note?

    • Material damage coverages

    • Covers required

    • Buildings

    • Basis of Building Settlement

    • Stock

    • Contents

    • Basis of Contents Settlement

    • Seasonal Stock Increase

    • Business Interruption 

    • Business Interruption

    • Loss of Insured Profit / Revenue
    • Cover type
    • Loss of Rent
    • Claim Preparation Costs
    • Additional Increased Cost of Working
    • Rewriting of Records
    • Payroll
    • Payroll / Wages - Dual Basis
    • Cover Type
    • Wages in Lieu of Notice
    • Book Debts
    • Redundancy Pay
    • Redeployment Expenses
    • Penalty Payments

    • Optional Extensions

    • Key Money
    • Do you wish to specify any Uninsured Working Expenses?
    • Commercial Motor 

    • Commercial Motor

    • Large Losses > $50,000
    • In the last 5 years, has any person who is likely to drive the insured vehicle(s):
    • Ever been charged with any breach of regulations relating to work time driving hours or log book rules?
    • Had any convictions or had any penalties imposed for driving under the influence of alcohol or drugs?
    • Had a driver's licence cancelled or suspended or restricted?
    • Been convicted or charged with any driving offences or traffic infringements (other than parking offences or speeding)?

    • Vehicle Details #1

    • Vehicle Details
    • Usage Details

    • Interested Parties

    • Optional Extensions

    • Loss of use
    • Portable Electronic Equipment

    • Vehicle Details #2

    • Vehicle Details
    • Usage Details

    • Interested Parties

    • Optional Extensions

    • Loss of use
    • Portable Electronic Equipment

    • Vehicle Details #3

    • Vehicle Details
    • Usage Details

    • Interested Parties

    • Optional Extensions

    • Loss of use
    • Portable Electronic Equipment

    • Vehicle Details #4

    • Vehicle Details
    • Usage Details

    • Interested Parties

    • Optional Extensions

    • Loss of use
    • Portable Electronic Equipment
    • Carriers Liability 

    • Period of Insurance

    • From
       - -
    • To
       - -

    • 1. The Cover

      Limits of Indemnity

    • Are you prepared to carry a larger excess than the standard $250?

    • Excluded products The policy excludes liability for loss to:

      1. jewellery, gold and silver articles, precious stones, bullion, cash, banknotes, deeds, bonds, bills of exchange and other documents representing money,
      2. aircraft of any kind including helicopters,
      3. accessories in or on any aircraft or helicopter,
      4. household goods and personal effects carried for the purpose of household removal, unless the insured did not know, and could not reasonably have known, that household or personal effects were being, or were to be, carried,
      5. office furniture carried for the purpose of office removal, unless the insured did not know, and could not reasonably have known, that office furniture was being, or was to be carried,
      6. tobacco or tobacco products.

       

    • Declared value risk or declared terms

    • 1.4 Do you require an extension of cover for any ‘declared value’ or ‘declared terms’ contracts, as defined by the Contract and Commercial Law Act 2017?
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    • 2. The Business

    • Rows
    • Rows
    • Rows
    • Rows
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    • 3.1 Do you employ subcontractors? (Please tick)
    • 3.2 If sub-contractors are employed, is your liability as principal to be covered whilst goods are in the custody
    • Contractors Plant & Machinery 

    • Gross Vehicle Weight: For trucks, trailers, mobile plant over 3,500kgs, please provide the gross laden weight (GLW Gross laden weight means the vehicle weight plus load capacity.

      Sum Insured: The Sum Insured must include all accessories and ancillary equipment fixed to or used with the insured item and must be no less than market value. GST does not need to be added.

    • Rows
    • Rows
    • Will any items be used for forestry work or logging or timber extraction in forests?
    • Will any items be used in mines or quarries?
    • Are any items used or designed to be used underground or have attachments used or designed
    • Do any items carry toxic chemicals, acids, explosives or other items considered dangerous?
    • Are any items hired out without your operator?
    • Are any items designed to be operated as a crane?
    • Is any item fitted with any fire suppression systems, anti-theft devices or fire extinguishers?
    • Has any item been altered from the manufacturer’s original specifications?
    • Is any item used in high country, mountainous or inaccessible terrain?
    • Will any item be used airside at an airport?
    • Does any item require the operator to have a specific license and/or receive specific training to ensure
    • Marine Cargo 
    • Rows
    • Rows
    • Method of declaration
    • Rows
    • Rows
    • Rows

    • Details of goods to be insured

      • Don’t underinsure. Use current market value as the basis for insuring your goods. When the sum insured is less than current value youmay become self insured for a part of any claim you make. example; if you underinsure by 50% any claim will be reduced by half plusthe amount of your excess.
      • Where we agree to insure goods for their cost of replacement, use the new replacement value figure when arriving at your sum insured.
      • Limited conditions of insurance cover will apply to goods shipped on deck if they are not packed in fully enclosed Iso shipping containersof solid wall and roof construction.
      • Limited conditions of insurance will apply to shipments carried on deck (unless shipped as protected stowage) and not packed in fullyenclosed Iso containers of solid wall and roof construction
    • Duty of Disclosure 

    • Duty of Disclosure

    • Rows

    • Claims

    • Any claims in the last 3 years?*
    • Period of Insurance Required
       - -
    • Renewal Date
       - -
    • Date
       - -
    • Should be Empty: