Our business pack question set covers the following sections, click NEXT and complete the form with as much details as possible. Fire & other specified perils Business Interruption Burglary Money Glass Liability Transit Electronic Computer Breakdown Machinery Breakdown General Property Tax Audit Employee Fraud Motor Vehicles Who This Enquiry Is For For us to provide the best response to your inquiry please complete the following This inquiry is for an existing business with current insurance This inquiry is for an existing business without insurance This inquiry is for a new business Contact Details First Name* Surname* Address Suburb / City Postcode Telephone Mobile* Fax Email* Business Details Name of the business* Describe your business What is the required start date of the insurance? Is your business premise address different to your contact address? No Yes Business street address Business suburb / city Business postcode Does your business operate from multiple sites? No Yes Age of building in years What is the roof made of? Tile Steel What are the walls made of? Brickwork Concrete Steel on steel Steel on wood What are the floors made of? Timber Concrete What type of alarm system is installed? Monitored Local None Fire & other specified perils Sum Insured Building $ Stock $ Contents $ Others (please specify) Description $ Business Interruption Indemnity Period 6 months 12 months Sum Insured Gross Profit $ Increased Working Cost $ Wages $ Rent $ Other $ Other Description Total $ Burglary Sum Insured Contents $ Stock $ Tobacco $ Combined contents / stock $ Other $ Other Description Money Sum Insured In Transit $ On Premises $ On premises outside $ Business hours $ In Safe $ Personal custody $ Other $ Other Description Glass Sum Insured Internal or External Internal - Replacement Value External - Replacement Value Signs $ Liability Sum Insured Payout $5 Million $10 Million $20 Million Turnover $ Wages Paid $ Staff Numbers $ Are you the property owner? No Yes Describe tenant's business Do you import products? No Yes Product 1 Country of origin 1 Product 2 Country of origin 2 Country of origin 3 Product 3 Transit Own Vehicles Maximum Value per load $ Annualised Total Carry $ Number of Vehicles # Professional Carriers Maximum Value per load $ Annualised Total Carry $ Electronic Computer Breakdown Describe equipment you wish to insure Sum Insured $ Machinery Breakdown Sum Insured Refrigerator Amount of units Units $ Air Conditioner Amount of units Units $ Other Amount of units Units $ General Property Describe equipment you wish to insure 'away from your business' (e.g. laptop computers) Sum Insured Tax Audit Sum Insured $ Employee Fraud Sum Insured $ Motor Vehicles Make and model Year Registration Number Main Driver Date Of Birth The vehicle is garaged No Yes Garage postcode NCB rating or rating number Use Business Private Under Finance No Yes Final Questions Prior to the Insurer accepting any risk they will require information about any claims over the past 5 years where the claims relate to the type of insurances you wish to take out. Please describe those claims: Email a copy to me Tick for yes CAPTCHA Phone This field is for validation purposes and should be left unchanged.