IMPORTANT NOTES
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.
1a.
Eligibility no.:
1b.
Licence/Registration no.:
2a.
Name (if different to the name on the contract, please provide a written explanation):
ABN:
ACN:
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)?
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)
3a.
Full site address
(NB. contract price must include GST)
4a.
Is the project speculative?
If "Yes" , go to Section 5. If "No" , please continue with section 4.
4b.
Type of contract?
4c.
Date contract signed:
4d.
Has construction commenced?
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.:
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:
6a.
Type of construction being undertaken – soil classification details are to be completed below:
6b.
Does this contract form part of a house and land package (new dwellings only)?
6c.
Does this contract include construction of a swimming pool?
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?
6l.
Does this project involve the refurbishment of an existing building?
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?
If "Yes" , please provide details:
6o.
Will any existing structures remain at this site following the completion of the project/contract?
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?
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?
If "Yes" , please provide:
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:
ABN:
6y.
Mortgagee/Interested party?
Note: The insurer reserves the right to seek further clarification of the works or a copy of the plans.
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