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Contract Works Insurance
Annual Policies

If you would prefer to talk to a broker first, please call 1300-881-779 between 8.15am and 5.15pm EST. business days.


Insured Name:

Trading Name:

ABN No.(if applicable): 

Address:

Suburb or town:
   

Postcode:

Email Address:

Telephone No:

Start date of business:

 

If you have already spoken to someone in our office, please note their name here so that this form can be processed by them as they will know something about you already.

Brokers Name:

 

Insurance Details

Maximum Project Duration (months)

Maximum Defects Liability Period

What type of Projects are being undertaken
(eg. Construction, alteration of residential buildings / units or
Construction of Commercial buildings, roads, bridges, marinas etc.)

 

Basis of Insurance for Projects

This policy is issued on a run-off basis.

Estimated value of projects to be started in the next 12 months? ($)

Estimated number of Projects to be started in the next 12 months?

 

Existing Structures...

Will any alterations or refurbishments to Existing Structures be undertaken? Yes    No
Do you require insurance cover for those Existing Structures? Yes    No
Will Existing Structures be occupied / tenanted during any Projects? Yes    No

 

Demolition Work...

What percentage of the Annual Turnover is derived from demolition work?   %

 

Projections...

In the next 12 months, will any Projects differ in size, scope or complexity
from those undertaken by you in the past 3 years?

Yes    No

If "YES", please provide details:

Maximum number of storeys

Maximum number of basement levels

 

Will the Projects Involve any of the following...

Is there any demolition involved? Yes    No
Construction of straw bale homes Yes    No
Blasting or explosives (other than nail guns) Yes    No
Buildings or structures of historical significance Yes    No
Underground works,tunnels,shafts,mines or galleries Yes    No
Any work in,on,over or under a permanent body of water Yes    No
Directional drilling or boring greater than 50cm in diameter (not pilings/piers) Yes    No
Swimming pools Yes    No
Schools, hospitals, universities,shopping centres, hotels or railway stations Yes    No
Technology which is of a prototype nature Yes    No
Will there be any retaining walls greater than 15m in length or 1.5m in height Yes    No
Will any work be done in flood prone or high annual rainfall zones

Yes    No

Maximum excavation depth (metres)

If Yes to any of the above questions, please describe.

 

Sum Insured (Material Damage)

Maximum contract price (Project value) of any one Project ($)

Maximum amount of Principal Supplied Materials for any one Project

Existing Structures (maximum value for any one Project)

Contractors Plant, Tools & Reusable Equipment (extra premium payable)
- Hand Tools
- Scaffolding / Formwork/ Sheds
- Plant (Contractors)

 

Sum Insured (Public Liability)

Please nominate the amount of cover you require:    


Type the above number:



Declaration...

By submitting this Declaration, I/we declare and agree that:
  • I/we have the consent of all other persons covered by this policy to make this Declaration,
  • the contents of this Declaration are true and complete,
  • I/we have read the information concerning the duty of disclosure (immediately below this declaration) and other important notices;
  • I/we have answered every question fully and frankly, have been truthful and accurate in completing this application and have not withheld any information likely to affect the acceptance of this insurance;
  • I/we realise that if I/we have not complied with the duty of disclosure, any claims may not be met
  • if anything happens during the Period of Cover which alters any of the information provided, I/we will promptly inform the insurer;
  • they authorise the insurer to give or obtain from other insurers or insurance reference bureaus or credit reporting agencies, any information about this insurance or any other insurance held by the Applicant/s.

Name of person making this declaration:


 

 

Duty of Disclosure - What you must tell us
Under the Insurance Contracts Act 1984 (the Act), you have a Duty of Disclosure. You are required before you enter into, renew, vary, extend or reinstate your Policy, to tell us everything you know and that a reasonable person in the circumstances could be expected to know, is a matter that is relevant to our decision whether to insure you, and anyone else to be insured under the Policy, and if so, on what terms.
  • You do not have to tell us about any matter
  • that diminishes the risk
  • that is of common knowledge
  • that we know or should know in the ordinary course of our business as an insurer, or
  • which we indicate we do not want to know.
  • If you do not tell us
If you do not comply with your Duty of Disclosure we may reduce or refuse to pay a claim or cancel your Policy. If your non-disclosure is fraudulent we may treat this Policy as never having worked.