On-line Home Warranty Insurance for Builders with up to $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 8):
1b. What date did this business commence trading:
1c. ACN:
1d. Does your business trade as a:
Sole Trader Partnership Company Trust
If "Trust" please attach a copy of the trust deed - please see Question 8
1e. What Builder Licence/s do you operate under?
1f. States/Territories of operation:
NSW VIC QLD SA WA TAS NT ACT
Section 2 - Building activity
2a. What is the maximum turnover limit you are seeking warranty insurance for in any one year? $ 
2b. What percentage of your proposed turnover is speculative (built on land owned by the applicant)? %
2c. Please indicate your turnover limit preference:
Active Insurable turnover limit (refreshed when jobs are completed)
Maximum (annual) insurable turnover limit (refreshed after 12 months from date issued)
2d. Past Experience:
Please provide a brief description of the largest projects over the past 5 years where you have been the builder, project manager or site supervisor (any work type)
Description Value of works Date completed Role on project
$
$
$
$
$
2e. New Project:
Please provide a brief description of the largest residential project you are seeking home warranty approval for.
Description Estimated Value of works ($)
2f. If the new project is significantly greater than your past experience as indicated above, please provide a summary of past experience or any supporting information available:
Section 3 - Statement of assets and liabilities
3. Please include below assets and liabilities for the applicant business and for each Director, Partner or Proprietor (If insufficient space, please provide the information as an email attachment - please see Question 8):
Real estate (Please attach a current rates notice or confirmation of settlement for each property - please see Question 8)
  Percentage owned* Estimated value Amount owing
Residential home located at:      
$ $
Other property/vacant land located at:      
$ $
$ $
$ $
$ $
Motor vehicles
Make, model & year Owner/s Estimated value Amount owing
$ $
$ $
$ $
Cash at bank
Name of bank Account name Current value
$
$
$
Overdraft/Lines of credit
Lender name Account name Approved limit Current balance
$ $
$ $
$ $
Credit card/Store card
Provider name Account name Approved limit Current balance
$ $
$ $
$ $
Plant & machinery/tools of trade Estimated Value Amount Owing
$ $
$ $
$ $
Other assets (Provide details e.g. shares etc) Estimated Value
$
$
$
Other liabilities (Provide details) Amount Owing
$
$
$
Work in progress - Work performed less Progress Payments already received Value
$
$
$
Trade debtors/Other monies owed to you Value
$
$
$
Trade creditors $
* Percentage of the property value owned by the directors, principles, partners of the business
Section 4 - Business financial summary
4a. Please complete this section:
  Last financial year available
ended 30/6/		 Previous financial year available
ended 30/6/
Total business turnover $ $
Net Profit before tax $ $
Director's wages and superannuation paid $ $
Value of retained earnings $ $
Where the Applicant trades under a Trust arrangement, please provide financial statements for a minimum of 2 years. (Please see Question 8)
4b. Where the Applicant has not traded for the last two years please provide details of activity/circumstances.
Section 5 - Business and personal background information
5. Has any director, partner, proprietor, principal/major shareholder or manager of your business:
a. Been involved in any way with any business that has been either insolvent, under administration or deregistered?
Yes No
b. Been subject to any personal deed of arrangement or act of bankruptcy?
Yes No
c. Been involved with any business where the statutory building dispute tribunal has made an order for rectification or payment?
Yes No
d. Been charged with or convicted of any criminal offence in the past 10 years?
Yes No
e. 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 or had any home warranty insurer pay claims?
Yes No
ii. had a builder's licence/registration refused, cancelled or suspended in any state or territory of Australia?
Yes No
6. Is your business currently eligible for Home Warranty Insurance with another insurer?
If Yes, please provide a current approved "Eligibility Letter/Certificate", together with a Work in Progress Report (available from your intermediary).
Yes No
7. Do you intend to claim less than 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 5-7 above:
8. 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
  • Any additional Statement of assets and liabilities information as requested in Section 3
  • A current rates notice or confirmation of settlement for each property as requested in Section 3
  • Copy of your current approved Eligibility Letter/Certificate, together with a Work in Progress Report as requested in Section 5


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:
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Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
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Your mobile phone number:
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Your email address:
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