1a.
What is the address of the property you wish to insure?
Strata Plan Number:
1b.
Post Code
1c.
What is the construction of the walls ?
1d.
What is the construction of the roof ?
1e.
What is the number of stories (other than ground floor)?
1f.
Age of building:
Years
1g.
How many lifts and/or escalator and/or hoists are there?
1h.
How many swimming pools and/or spas are there?
1i.
Are there any other recreational facilities other than swimming pools and / or spas?
If Yes, what are they?
1j.
Are any parts of the buildings used for any purpose other than residential?
If Yes, describe what that part is used for:
1k.
Are the buildings managed by an authorised strata manager or strata management company?
If Yes, what is the name of the person or company?
2a.
What is the replacement cost of your building?
$
2b.
How many units are to be insured?
2c.
Are the buildings residential or commercial?
3.
Please select the the amount of Liability cover required:
4.
What is the amount of Fidelity cover required?
$
5.
What is the amount of Office Bearers Liability cover required?
$
Cover is for injury while engaged in administrative or light maintenance duties arranged
by the Body Corporate.
6.
Do you want cover for Personal Accident?
If Yes, how many units of cover do you require? (Each Unit provides $10,000 C???? benefits or $100 per week)
units
7.
Do you want cover for Workers' Compensation for person employed in connection with owning, operating and managing the buildings?
Some circumstances make Workers' Compensation compulsory if you have employees. (If unsure check with your local Workers' Comensation Authority)
If Yes , for what amount?
$
8.
Have any of the applicants suffered any losses or had any claims
made against them within the last 5 years, whether claimed or not?
If Yes , complete the following details:
9.
Have any of the applicants or any person who will receive insurance
cover under the proposed policy, been charged with or convicted of any
criminal offenses during the last 10 years?
If Yes , provide details:
10.
How many people are members of the council or committee or governing body of the committee?
11.
Of these people, how many are owners of a unit/lot or flat?
12.
Is a member aware of claims made or circumstances which may result in
claims being made against them or their predecessors in their capacity
as members of the committee or the governing body?
If Yes , provide the changes:
13.
Do you employ a caretaker?
If Yes , state the estimated annual salary or wages:
$
14.
Do you employ any other persons in connection with the building?
If Yes , state their
15.
Do you employ any other persons in connection with any other trade or business?
If Yes , state their occupation(s) / trade(s)
16.
Do you have a Workers' Compensation policy for these trade(s) or business(es)?
If Yes , state the name of the insurance company and policy number