Builders Home Warranty Insurance


Thank you for considering our on-line builders home warranty insurance service.   Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right builders home warranty for you.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deals that fit your requirements.


1a. Trading name (if different to business name you provide in the Contacting You section at the end of this page):
1b. Date Business Commenced:
1c. Type of business (Company/Trust/Partnership/Sole Trader):
1d. States/Territories in which eligibility is being sought
Areas Of Operation Builder's Licence Number Eligibility Sought?
NSW
VIC
SA
WA
ACT
TAS
NT
QLD
1e. Trade Association Membership:
MBA - Membership Number:
HIA - Membership Number:
Other - Association Name - Membership Number:
2. Particulars of Principals:
Principal 1
Name of Principal Address Phone Nbr Date Of Birth
Builder's Licence Nbr Driver's Licence Nbr Year Started In The Industry Year Started Running Own Business
Principal 2
Name of Principal Address Phone Nbr Date Of Birth
Builder's Licence Nbr Driver's Licence Nbr Year Started In The Industry Year Started Running Own Business
Principal 3
Name of Principal Address Phone Nbr Date Of Birth
Builder's Licence Nbr Driver's Licence Nbr Year Started In The Industry Year Started Running Own Business
Principal 4
Name of Principal Address Phone Nbr Date Of Birth
Builder's Licence Nbr Driver's Licence Nbr Year Started In The Industry Year Started Running Own Business
Resume/CV: If not contained on your website, please copy & paste or email a brief resume for each Principal and/or Director.
Business and Personal Background
3 Has any director, proprietor, major shareholder or manager of your business:
a. Ever been involved with a business placed into external administration, a scheme of arrangement, liquidation, provisional liquidation or receivership?
Yes No
b. Ever been declared bankrupt, entered into a deed of assignment, composition, scheme of arrangement with creditors, or been subject to legal judgement or currently have legal proceeding pending?
Yes No
c. Have any information of a 'material' nature not disclosed in the financial statement that could affect the financial position, capital structure or operation of the Application? Information is 'material' if its non-disclosure could influence 'Eligibility' accepatnce/decisions that GNG might make on the basis of the financial statements/information provided?
Yes No
d. Ever had a builder's licence/registration refused, cancelled or suspended in any state or territory in Australia?
Yes No
e. Ever been refused Home Warranty Insurance?
Yes No
f. Ever had a claim made against them or is aware of any circumstances that may give rise to a claim against them for Home Warranty Insurance?
Yes No
g. Ever had a penalty imposed on them by a Court or Tribunal in relation to residential home building?
Yes No
h. Or any related parties or business given any form of security to another Home Warranty Insurer (eg. Deed of Indemnity.Assurance, Bank Gurantee, Personal Guarantee or similar document)?
Yes No
If you answered Yes, to any of these questions, please provide details:
4. Do you currently hold a Letter of Eligibility for Home Warranty Insurance with any other Insurer?
Yes No
If yes, please provide details below:
Expiry date:
Insurer:
Annual Turnover: $
Number of Jobs: $
5. Has your business entered into any cross guarantees or indemnities with another realted or unrelated party where the other part provides finance to homebuyers for the purchase of homes built by your business?
Yes No
If you are seeking eligibility of more than $25 million, you must provide details of this agreement:
Building Activity
6. Previous Years Activity:
* For multi unit or unit/duplex/villa work 'No of Jobs' means the total number of dwellings in each project
Type of Work Description Year Ending 30/6/ Year Ending 30/6/ Year Ending 30/6/
No of Jobs* Value($) No of Jobs* Value($) No of Jobs* Value($)
Single Dwelling Contract Home
Single Dwelling Display/Speculative
Alterations & Additions Structural Modifications
Imporvements & Renovations Non-Structural Modifications
Swimming Pools
Unit/Duplex/Villa Less than 3 dwellings per site
Multi-unit development More than 3 dwellings per site
High rise Residential greater than 3 storeys
Residential project management
Sub contract
Commercial and Industrial Work
Total Turnover
7. Three largest projects in the last three years:
Type of Work Number of Units Largest Unit Value Contruction Period (days) Total Project Value
1. $ $
2. $ $
3. $ $
8. Do you intend to undertake any architect/designer tendered projects in the next 12 months?
Yes No
If Yes, please provide written references from two referees you have completed architect/designer work for and whether these proposed projects will be supervised:
9. Please outline the quality control and risk management systems you employ and attach evidence of these systems together with any supporting promotional material. (Do not include details of occupational health and safety systems)
10. Has the business received any awards for building excellence?
Yes No
If Yes, please provide details:
Financial Information
11. Anticipated activity for next 12 months:
* For multi unit or unit/duplex/villa work 'No of Jobs' means the total number of dwellings in each project
Type of Work Description No of Jobs* total value of contracts($)
Single Dwelling Contract Home
Single Dwelling Display/Speculative
Alterations & Additions Structural Modifications
Imporvements & Renovations Non-Structural Modifications
Swimming Pools
Unit/Duplex/Villa Less than 3 dwellings per site
Multi-unit development More than 3 dwellings per site
High rise Residential greater than 3 storeys
Residential project management
Sub contract
Commercial and Industrial Work
Total Turnover
Maxiumum Single Job Value
12. Three largest trade suppliers in the last three years:
Supplier Name Account Number Account Limit Phone Number Fax Number
1. $
2. $
3. $
13. Your Accountant:
a. Firm Name:
b. Accountant Name:
c. Phone Number:
d. Fax Number:
14. What job costing system do you implement - manual, customised conputer system (pleae specify details) or recognised computer system? (please specify name):
15. What computer based accouting package do you use?
16. What is the frequency of your financial reporting?
Annual Quarterly Monthly
Statement of Personal Assests & Liabilities
This section must be completed by each principal of your business. You must provide proof of ownership of assets together with evidence of any amounts owed.
17. Name:
ASSETS VALUE LIABILITIES OWING
Principal residence at: Mortgage with:
$ $
Property 2:
$ $
Property 3:
$ $
Property 4:
$ $
Vehicle 1:
$ $
Vehicle 2:
$ $
Vehicle 3:
$ $
Cash at bank: $ Credit Card debt: $
Limit: $
Other assets/investments:
$ $
$ $
$ $
Total: $ Total: $
Business Working Capital Statement
Information contained in this statement must not be more than 3 months old.
18a. Date of statement:
18b. Current No Jobs:
18c. Total value: $
19. ASSETS (List here the details of cash and other assets that are expected to be consumed or converted into cash within twelve months. Non-current asssets are not to be included):
Cash at bank: $
Work-In-Progress: $
Debtors: $
Land: $
Other amounts due in next 12 months: $
Please describe other amounts due in next 12 months:
Total: $
20. LIABILITIES (List here the details of all liabilities that are at call, due or expected to be settled within tweleve months. Non-current liabilities are not to be included):
Overdraft balance: $
Overdraft limit: $
Suppliers: $
Sub-Contractors: $
Tax: $
Other amounts due in next 12 months: $
Please describe other amounts due in next 12 months:
Total: $


Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address:
Country: