LICENSED BUILDERS – ANNUAL INSURANCE COVER

Please select the term of cover you are applying for, from the tabs below

BUSINESS DETAILS

Contact Person

Business Entity Name

Contractors License Number

Phone

Email Address

Street Address

Suburb

State

Postcode

INSURANCE DETAILS

Public Liability

Estimated Annual Turnover

Material Damage Excess (higher excess reduces annual premium)

Legal Liability Excess (higher excess will reduce the annual premium)

Policy Start Date

Financial Interested Party

Description of business activity (Ensure percentage total equals 100):

Registered builder undertaking residential construction including new and alterations only

Registered builder undertaking commercial construction including new and alterations only

Registered builder undertaking both residential and commercial including new and alterations only

Registered builder undertaking industrial work Civil contractors

Other (including incidental activities not catered for within the above descriptions)

In which state will your construction activities be carried out in? (Ensure total % equals 100)

NSW

QLD

VIC

ACT

TAS

Above 25th Parallel

Location – where will the majority of the construction works be carried out?

Do you have current insurance in place?

If yes, who is the current insurer?

How many years have you been insured for this business?

UNDERWRITING QUESTIONS

Have you or any proposer, any partner(s), shareholder(s) or director(s) of the business:

1. Made 2 or more claims on an insurance policy for loss or damage in the past three (3) years or any claims in excess of $10,000 either individually or cumulatively in the past five (5) years?

YesNo

2. Had any insurance declined or cancelled, application rejected, renewal refused, claim rejected, special conditions or excess imposed by an insurer?

YesNo

3. Suffered any loss or damage which would have been covered by the proposed insurance policy greater than $50,000 either individually or cumulatively?

YesNo

Have you or any partner(s), shareholder(s) or director(s) of the business:

4. Ever been declared bankrupt, insolvent or placed into administration?

YesNo

5. Been convicted of any criminal offence?

YesNo

Do you undertake or assume responsibility for any of the following:

6. Projects Valued Over $5,000,000?

YesNo

7. Civil works and/or earth works not associated with a total building contract (incl road or sub-divisions)?

YesNo

8. Excavation more than 5 metres in depth or contracts involving works at height of greater than 5 stories?

YesNo

9. Works on, in, over or under Water?

YesNo

10. Work involving Special Hazards (eg: Blasting or work around petroleum, steel or heavy industries such as automobile manufacturing facilities, mining, petroleum, chemical or steel industries, paper production, power generation, stone, mineral, oil, gas or metal extraction or production, printing or explosive atmosphere processes, tunnelling, micro tunnelling, pipe-jacking, and directional drilling)?

YesNo

11. Work taking place on, in or around aircraft or watercraft ?

YesNo

12. Work with Asbestos?

YesNo

13. Work involving piling, shoring greater than 1m in height or underpinning?

YesNo

14. Work to Heritage Buildings?

YesNo

15. Work involving house raising, restumping or relocating ?

YesNo

16. General Liability for vacant land of more than 2 lots ?

YesNo

17. Where responsibility is assumed from another builder after commencement of works ?

YesNo

18. Product imports / re branding / re packaging?

YesNo

19. Erection of machinery or plant (EAR Risks) unless the component is part of residential or commercial building construction and is less than 20% of the total contract value?

YesNo

20. Demolition Works other than work incidental to the main contract and involving stand alone structures on the contract site not exceeding 10 metres in height?

YesNo

21. Business activities as a Labour Hire company?

YesNo

22. Works involving prototype or experimental materials or construction methods?

YesNo

23. Work involving Educational Institutions, Medical complexes and Shopping centres?

YesNo

24. Work outside of mainland Australia and Tasmania?

YesNo

25. Work involving swimming pool only contracts, landscaping only contracts or waterproofing only contracts?

YesNo

26. Are payments to Labour Hire companies for the next 12 months estimated to be 20% or more of total estimated turnover?

YesNo

Annual Policy – Existing Projects

27. Do you require cover for projects that have already commenced?

YesNo

Provide any additional information that may assist with your application

General Advice
I confirm that I have read the Financial Services Guide and understand that BuildInsure have not taken into account my/our individual objectives, financial situations or needs.

Declaration
I declare that I have read and understood the duty of disclosure notice contained in the Important Notices and the statement and particulars in this proposal form are true and that no material facts have been misstated or suppressed after enquiry.

I further agree that should any of the information given by me alter between the date of the proposal and the inception date of the insurance to which this proposal relates, I will give immediate notice to BuildInsure.
I consent to the use and disclosure of my personal information (and that of any other persons to whom this application relates) in accordance with the "Privacy Statement" contained in the Important Notices.

I agree that this proposal, together with any other information supplied by me shall form the basis of any contract of insurance effected thereon.

Click here - to view the Financial Services Guide
Click here to view the Privacy Statement.

I have read and agree to the above declaration.