On-line Home Warranty Insurance Job Specific Multi-Dwelling Application

Thank you for considering our on-line 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 home warranty insurance 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.

This form is to be used where policies are required for contract/s exceeding $1.5M in value and/or consists of more than six (6) dwellings on the one site. One form is required to be submitted for each multiple dwelling construction contract.
Section 1 - Contractor/Builder information
1a. Eligibility no.:
1b. Licence/Registration no.:
Section 2 - Owner/Developer information
2a. Name (if different to the name on the contract, please provide a written explanation):
2b. Current contact address:
2c. Current contact person:
2d. Contact telephone no.:
2e. Is there any relationship between the builder and owner (eg. family members, common directorship/shareholding, joint ownership of land, affiliated company, etc)?
Yes No
If "Yes", please provide details explaining the related party interests and a copy of the financial reports if the owner and builder have common directors or shareholders. (Please see Question 8)
Section 3 - Site location
3a. Full site address
Stage no. (for multiple stage projects – i.e. stage 1 of 2) No. of units
Lot no. Street no. Street name Suburb/Town
State Postcode Shire/Council
Section 4 - Contract information (Please attach a copy of the executed building contract - Please see Question 8)
(NB. contract price must include GST)
4a. Is the project speculative?
Yes No
If "Yes", go to Section 5. If "No", please continue with section 4.
4b. Type of contract?
Fixed Price contract Contract Price: $ Estimated builders profit margin: %
Cost plus contract Contract Budget: $ Actual builders profit margin: %
Other (please advise the basis of contract in brief)
4c. Date contract signed:
4d. Has construction commenced?
Yes No
If "Yes", please advise:
i. date of commencement:
ii. type and stage of works completed to date (i.e. basic site preparatory works):
iii. parties that have undertaken this work:
iv. value of works completed to date: $
4e. Estimated start date of residential construction work:
4f. Estimated completion date:
4g. Builder’s contract/Job reference no.:
Section 5 - Speculative development (Please provide a copy of the council Rates Notice - Please see Question 8)
NB. A project where the Contractor/Builder who owns land carries out residential building work on it.)
5a. Construction Cost Budget: $
5b. Margin % or $:
5c. Estimated start date:
5d. Estimated completion date:
Section 6 - Project information
6a. Type of construction being undertaken – soil classification details are to be completed below:
Structural Non-Structural
6b. Does this contract form part of a house and land package (new dwellings only)?
Yes No
6c. Does this contract include construction of a swimming pool?
Yes No
6d. Please provide a brief description of the work being undertaken (e.g. list the number of dwellings being constructed, an overview of prior/future stages of development on this site, details of any site preparation or other construction work, number of bedrooms in each type of dwelling, construction type).
6e. Building materials used in the construction (ie. solid brick, brick veneer, weatherboard, etc):
6f. Roofing materials used in the construction (ie. tile, slate, steel, etc):
6g. Number of residential storeys:
6h. Number of non-residential storeys:
6i. Number of parking levels above ground:
6j. Number of parking levels below ground:
6k. Does this property contain lifts?
Yes No
6l. Does this project involve the refurbishment of an existing building?
Yes No
If "Yes", please provide details (e.g. structural/non-structural works required):
Estimated Construction Cost: $
6m. Please provide a description of any non-residential construction works within this contract and its estimated construction cost (e.g. ground floor commercial units, retail units etc.):
Estimated Construction Cost: $
6n. If a building contract, will the owner/developer be undertaking any work or be supplying any of the materials?
Yes No
If "Yes", please provide details:
6o. Will any existing structures remain at this site following the completion of the project/contract?
Yes No
If "Yes", please provide details of any construction work to be undertaken on those structures:
6p. Is there any intention to effect settlements with subsequent owners prior to completion of the dwelling/s?
Yes No
If "Yes", please provide details:
6q. What is the Soil Classification for this project?
For soil classifications of H, E or P, footings details must be included:
6r. Name of geotechnical engineer/civil engineer who classified the site:
6s. Name of person who engaged this engineer:
6t. Is this an architect/designer tendered project?
Yes No
If "Yes", please provide:
Name of architectural firm Contact name Contact telephone no.
6u. Estimated construction cost of:
i. Excavation/Retaining work: $
ii. Paving/Roadworks work: $
iii. Landscaping/Swimming pools/Recreational facilities: $
6v. When will the units be offered for sale? (i.e. off plan, during construction, upon completion):
6w. What percentage of residential units have already been sold? (if any): %
6x. Party who will hold deposit monies for these on sales:
6y. Mortgagee/Interested party?
Note: The insurer reserves the right to seek further clarification of the works or a copy of the plans.
Section 7 - Construction finance information
7a. Name of the project/contract financier(s) (e.g. Bank):
7b. Please provide a copy of the final offer document issued by the financier(s) (please see Question 8) and advise details of any agreement(s) which have or will be entered into between the builder, developer and financier(s):
8. Supporting Documentation
Please email/fax/mail the following documentation in support of your application:
  • Copy of the financial reports if the owner and builder have common directors or shareholders as requested in Section 1
  • Copy of the executed building contract as requested in Section 4
  • Copy of the council Rates Notice as requested in Section 5
  • Copy of the final offer document issued by the financier as requested in Section 7

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 below:
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:
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: