Insurance Multi Product Quote Form About YouName(Required) Full Name Phone(Required)Email(Required) Business NameABNAddress(Required) State Post Code ReferralInsurance Types You Are Interested In(Required) Truck Insurance Commercial Property Insurance Cafe, Restaurant & Hospitality Insurance Plant and Machinery Public Liability Insurance Trades and Construction Insurance Home & Contents Business Insurance Landlord Insurance Travel Insurance General Inquiry Farm Insurance Motor Trades Insurance What Trade & Contractor Insurances would you like to cover?(Required) Public Liability General Property (inc. Tools) Personal Accident & Sickness Builders & Contract Works Work Vehicle Insurance Select AllInsurance HistoryAre you currently insured?(Required) Yes No Current / Previous InsurerExpiry Date Have you had any claims, convictions or bankruptcy??(Required) Yes No Please provide details of prior claims, convictions, or bankruptcy Truck InsuranceOvernight Parking AddressPostcodeWhat do you transport?Truck Count(Required) Single Truck Multiple Trucks Year, Make, Model(Required)RegoSum InsuredAge of Main DriverHow many trucks do you have in your fleet?(Required) Commercial Property InsuranceProperty Address to be InsuredPostcodeNumber of TenantsTenant Occupation(s)Annual rental amount or estimated turnoverWhen was the building first built?Buildings Sum Insured Cafe, Restaurant & Hospitality InsuranceIndustry Description (e.g. licensed bar, restaurant, cafe, takeaway, hotel, accommodation)Property AddressPostcodeDo you serve alcohol on site? Yes No Do you use deep fryers? Yes No Estimated Annual Revenue / TurnoverWhat insurance covers would you like us to include in your quote?(Required) Public & Product Liability Business Property (Building, Contents, Stock) Theft or Burglary Business Interruption Machinery Breakdown General Property (Tools) Unsure – I’d like some guidance Select All Motor Trades InsuranceIndustry Description (e.g. mechanic shop, mobile mechanic, tyre shop, etc.)Property AddressPostcodeEstimated Annual Revenue / TurnoverWhat insurance covers would you like us to include in your quote?(Required) Public & Product Liability Business Property (Building, Contents, Stock) Theft or Burglary Business Interruption Machinery Breakdown General Property (Tools) Glass Commercial Motor Unsure – I’d like some guidance Select All Plant and MachineryEquipment Description (Year, Make, Model)(Required)Occupation(Required)Normal Parking Address Street Address City State / Province / Region ZIP / Postal Code Sum Insured(Required) Public Liability InsuranceTell us about your public liability insurance needs Trades and Construction InsuranceFull Occupation and activities(Required)Please Select OneAir Conditioning (Installation / Servicing)BricklayerOwner BuilderRegistered BuilderBuilders LabourerCarpenter / Cabinet MakerCarpet CleanerCarpet LayerCleanerEarthmovingElectrician – DomesticElectrician – CommercialFencing ContractorGlazierHandymanLandscaper, Lawn mowing, GardeningPainter / PlastererPlumberPool ServicesRoofingStonemasonShop FitterTilerOtherOther Occupation(Required)Detail of Activities(Required)Public Liability InformationSelect your Liability cover limit(Required) $10,000,000 $20,000,000 Estimated Business turnover(Required)Estimated payments to contractorsEstimated payments to Labour HireNo. of employees and directors (including yourself)(Required)Sole Trader2-56-1515-25Over 25Employment status of employees(Required)Full TimePart TimeMixedMaximum height you work atDo you work airside? Yes No Do you do any work involving swimming pools? Yes No General Property InformationTotal sum insured for required for full replacement(Required)Any single items over $2,000 individually? Item Description Sum insured (value) Actions Edit Delete There are no Insured Items. Add Insured Item Maximum number of insured items reached. Personal Accident & Sickness InsuranceDate of birth(Required) Your taxable income over the past 12 months(Required)Gross Weekly Benefits Enter a figure you wish to insure for. This can be anywhere up to your taxable income over the last 12 months after business expenses.Weekly Accident BenefitWeekly Sickness BenefitBenefit Period(Required) 52 Weeks 104 Weeks Permanent Disability/Death Benefit Enter a figure you wish to insure for in the event you became Permanent Disabled or Passed AwayCapital Benefit Sum insured Landlord InsuranceAddressDOB of oldest insured person Required Start Date When was the building was first constructed?Occupancy TypeLong Term TenantsShort Term Tenants (Air BNB)Holiday HomeProperty typeRoof Construction (Colorbond, Tiles, Concrete etc)External wall constructionBuilt onNumber of StoreysNumber of BedroomsNumber of BathroomsBuildings Sum InsuredContents Sum Insured (any curtains, carpets, blinds, white goods)Rental Amount Per Week (approximately is fine)What type of security exists on accessible doors (deadlocks, security doors, key card access)What type of security exists on accessible windows (security screens, key operated)What type of burglar alarm system Home & Contents InsuranceDOB of oldest insured person Required Start Date AddressWhen was the building was first constructed?Property typeRoof ConstructionExternal wall constructionBuilt onNumber of StoreysNumber of BathroomsNumber of BedroomsBuildings Sum InsuredContents Sum Insured (any curtains, carpets, blinds, white goods)What type of security exists on accessible doors (deadlocks, security doors, key card access)What type of security exists on accessible windows (security screens, key operated)What type of burglar alarm system Travel InsuranceTell us about your travel insurance needs General InquiryBusiness InsuranceFarm InsuranceTell us about your insurance needs
