Commercial Property Owners Quote Form

Commercial Property Owners Quote Form
Insured Name*
Contact name*
Email*
Retype email*
Telephone Number:
Risk Address of Property to be insured*
Suburb*
State
Post Code*
Prefer Monthly or Annual
Building Construction Walls
Does Building contain EPS - Sandwich Foam Panel construction (Includes Structural or Non-structural) if so what %
Buildings Frame
Buildings Roof
Buildings Floor/s
Approximate year Built
Number Of Stories/levels
Please list ALL tenants and their occupations & approximate percentage that they occupy of the building as this is required to calculate your insurance premiums
List of Tenants who occupy your building*
Fire Protection

Fire Alarm back to baseHard Wired Smoke alarmBattery smoke alarmsFire extinguishersFire hose reelNone-No fire protection
Security Protection

Deadlocks all external doorsKey operated window locks all windowsBars or Grills all windowsBack base monitored alarmLocal alarmNormal key locks onlyNo securitySecurity Patrol
Any Hazardous Goods stored at property to be insured
Please provide some details of Sums insured or Cover required as this is required to calculate your insurance premiums
BUILDING SUM INSURED
CONTENTS SUM INSURED
ANNUAL LOSS OF RENT SUM INSURED
PROPERTY OWNERS LIABILITY
ANNUAL RENTAL*
Are You Owner & Occupier of Building
GLASS COVER
Are tenants responsible to insure Glass
MACHINERY BREAKDOWN
IF YES TO MACHINERY BREAKDOWN PLEASE LIST ITEMS, SIZE OF MOTOR & REPLACEMENT SUM INSURED
HISTORY DETAILS ( if you answer yes to any of the below questions please provide further information in free text box below)
Has the insured or any Directors had any claims in the last 5 years*
Has the insured or any Directors had any criminal convictions in the last 10 years*
Has the insured or any Directors had a claim refused, insurance declined or any special conditions imposed in the last 5 years*
Is the insured or any Directors aware of any circumstance that may lead to a claim*
CURRENT INSURER
Expiry Date of current Insurance or date to start cover

MonthDayYear
ANY OTHER INFORMATION PLEASE USE THIS TEXT BOX
ANY OTHER INSURANCE YOU WANT QUOTES ON SUCH AS BUSINESS,MOTOR, LANDLORDS, HOME & CONTENTS, WORKERS COMPENSATION PLEASE USE THIS TEXT BOX
DUTY OF DISCLOSURE ( Please ensure all details are correct as answers on this form will be used to obtain quote and or cover and if incorrect or not disclosed information this could affect a claim being paid)
Should be Empty:

Commercial Property Owners Quote Form

Please list ALL tenants and their occupations & approximate percentage that they occupy of the building as this is required to calculate your insurance premiums

Please provide some details of Sums insured or Cover required as this is required to calculate your insurance premiums

HISTORY DETAILS ( if you answer yes to any of the below questions please provide further information in free text box below)

DUTY OF DISCLOSURE ( Please ensure all details are correct as answers on this form will be used to obtain quote and or cover and if incorrect or not disclosed information this could affect a claim being paid)