On-line Home Warranty Insurance for Builders with over $3 Million Turnover


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.


Section 1 - General (all applicants to complete):
1a. Trading name(s) (please attach a copy of your certificate of Business Registration - please see Question 11):
1b. What date did this business commence trading:
1c. ACN:
1d. Does the Applicant business trade as a:
Sole Trader Partnership Company Trust
If "Trust" please attach a copy of the trust deed (please see Question 11)
1e. Trades Association?
H.I.A M.B.A Other - Please specify
1f. States/Territories of operation:
NSW VIC QLD SA WA TAS NT ACT
Section 2 - Building activity
2a. Please provide a breakdown of the various types of construction: (Contract price to include GST).
Greater National Group will recognise your prior construction experience when providing home warranty insurance.
In some instances further information may be sought to enable Greater National Group to better understand your business.
  Past 12 months Proposed for next 12 months
Type of construction Total value of all
projects		 Estimated total
value of all
projects		 Estimated
number of
projects		 Estimated largest
single contract ($)
Single dwelling – new construction $ $ $
Dwelling improvements – Structural $ $ $
Dwelling improvements – Non-structural $ $ $
Units/Villas/Townhouses –
6 or more units (not high rise)		 $ $ $
Transportable/Relocatable homes $ $ $
Swimming Pools $ $ $
Subcontracting (not requiring warranty) $ $ $
High rise residential construction $ $ $
Other (Please specify)
 $ $ $
Total $ $ $
2b. What percentage of your proposed activity is on a cost plus or contract management basis? %
2c. What percentage of your proposed activity is on a speculative basis? %
2d. What annual Home Warranty turnover limit do you require? $
2e. What is the estimated maximum value of all projects requiring Home Warranty Insurance which may be under construction at any one time? $
2f. Please indicate your turnover limit preference:
Active Insurable turnover limit (refreshed when jobs are completed)
Maximum (annual) insurable turnover limit (refreshed with job values after 12 months from issued date)
3. Average construction cycle
a. Construction Lead-Time (i.e. period from contract signing/deposit taken until starting on site): weeks
b. Construction Phase (i.e. period at site until handover to homowner/developer): weeks
4. Please provide a brief description of the largest projects over the past 5 years (any work type):
Description Value of works Date completed Your Role on project
$
$
$
Section 3 - Builder licence/registration/accreditation information
5. Please list all Building licences held by the business entity (including nominated officers)*:
Issuing state Name on licence Licence no. Year first issued
* Nominated officers to include Licensed Supervisors, Practitioners, Directors, Project Managers, Supervisors etc.
Section 4 - Financial Information Required
6. To enable assessment of your application, we require the following financial information (please see Question 11):
  • Full and final Financial Statements (being the Profit and Loss Statement with Trading Statement, Balance Sheet, and Notes to Accounts) for the last three (3) financial years. These must be prepared by a suitably qualified Accountant and signed by the Applicant as being true and correct.
  • Should the end of the last financial year be more than 9 months ago, we also require, in addition to the above, interim Financial Statements (being the Profit and Loss Statement with Trading Statement, Balance Sheet and Notes to Accounts) for a period of at least 6 months ended since the last financial year-end.
  • For Sole Traders only – the Financial Statements required incorporate the Profit and Loss Statement with Trading Statement only (or a copy of the Tax Return as submitted to the Australian Taxation Office), and may exclude a Balance Sheet. All other requirements as above remain unchanged.
  • If you have not been actively building for the past 12 months (or longer), please attach a summary of employment for this period along with details of your prior building experience.
6a. Trust type:
N/A Discretionary Unit Fixed Other - Please specify
Note: In need, please clarify type with your Accountant/Financial Adviser.
6b. Trust name:
6c. Trustee:
Please provide a signed copy of the Trust Deed (please see Question 11).
Section 5 - Business and personal background information
7. Has any director, partner, proprietor, principal/major shareholder or manager of your business. (If insufficient space, please provide the information as an email attachment - please see Question 11):
a. Been involved with a business (including the Applicant) where the Statutory building dispute Tribunal has made an order for rectification or payment or aware of any Court, Tribunal or arbitration hearing involving or in any way related to home building work undertaken by your business?
Yes No
b. Been involved with a business placed in external administration, a scheme of arrangement, receivership, liquidation or provisional liquidation?
Yes No
c. Been declared bankrupt, entered into a deed of assignment, composistion, scheme of arrangement with creditors, or been subject to a legal judgement or currently have legal proceedings pending?
Yes No
d. Been charged with or convicted of any criminal offence in the past 10 years?
Yes No
e. Had an application for home warranty insurance rejected, delined or withdrawn by an insurer or required special terms to be applied by an insurer?
Yes No
f. Been a director, partner, princiapl/major shareholder or manager of a business that has:
i. had an application for home warranty insurance rejected, declined or withdrawn by an insurer or required special terms to be applied by an insurer?
Yes No
ii. had a builder's licence/registration refused, cancelled or suspended in any state or territory of Australia?
Yes No
iii. had a home warranty insurer ever pay a claim?
Yes No
iv. given any form of security to another Home Warranty Insurer (e.g. Deed of Indemnity/Assurance, Bank Guarantee, Personal Guarantee or similar document)? If Yes, please advise when the security was provided, the name of the Insurer, to whom it was provided and the amount of any Bank Guarantees.
Yes No
v. aware of any circumstances that may give rise to a claim (e.g. any notification of a claim from your current or prior home warranty insurer, or from any current or former client)?
Yes No
8. Is your business currently eligible for Home Warranty Insurance with another insurer?
If Yes, please provide a copy of your current approved "Elibility Letter/Certificate", together with a Work in Progress Report (available from your intermediary) (Please see Question 11).
Yes No
9. Do you intend to claim 100% of your input tax entitelments for the GST applicable to future policy premiums?
Yes No
If No, please advise what percentage you intend to claim: %
Please provide a detailed explanation to any questions answered 'Yes' to questions 7-9 above:
Section 6 - Statement of assets and liabilities - personal
10. Please include below assets and liabilities for the applicant business and for each Director, Partner or Proprietor:
Please list the persons/ parties whose assets and liabilities have been included within the Table:
Real estate (Please attach a current rates notice or confirmation of settlement for each property - see Question 11)
Location: Percentage owned Estimated value Amount owing
$ $
Other property/vacant land:      
$ $
$ $
$ $
$ $
Motor vehicles
Make, model & year Owner/s Estimated value Amount owing
$ $
$ $
$ $
Cash at bank
Account Account owner/s Credit Balance
$
$
$
Overdraft/Lines of credit
Account Account owner/s Limit Approved Balance Owing
$ $
$ $
$ $
Credit card/lines
Account Account owner/s Limit Approved Balance Owing
$ $
$ $
$ $
Plant & machinery/tools of trade Value
$
$
$
Other assets (e.g. listed shares) Value
$
$
$
Other liabilities Amount Owing
$
$
$
Section 7 - Required Documentation
11. Supporting Documentation
Please email/fax/mail the following documentation in support of your application:
  • Copy of your certificate of Business Registration as requested in Section 1
  • Copy of your trust deed as requested in Section 1 and Section 4
  • Financial Information as requested in Section 4
  • Copy of your current approved Elibility Letter/Certificate, together with a Work in Progress Report as requested in Section 5
  • Any additional Statement of assets and liabilities information as requested in Section 6
  • A current rates notice or confirmation of settlement for each property as requested in Section 6


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:
ABN:
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Your mobile phone number:
Best time(s) to call:
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Your email address:
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