LICENSED BUILDERS
Single Project Insurance Cover Form

Please complete the form below.

    BUSINESS DETAILS

    INSURANCE DETAILS

    Do you require insurance cover for existing structures?

    Description of business activity (select one):

    UNDERWRITING QUESTIONS

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

    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.