City Rural

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Trades Pack

Trades Pack Insurance is setup with your specific trade and tools in mind. This policy may cover only your tools and public liability or include your office and/ or workshop. We will also include trade specific options to increase your level of cover.

In order for City Rural Insurance Brokers to provide you with an Obligation Free Quote, please complete the following.

Fields designated in RED are required to be completed

GENERAL INFORMATION
Insured's Name
Trading Name	Subsidiaries
Contact Name
Postal Address	Suburb/Town
State	Postcode
Email Address	Phone
Fax	Mobile Phone
Preferred method of contact Email Phone Fax	Occupation
Experience (Business) Yrs
Current Insurer	Expiry date

Has any insurer in respect of any insurance policy held by you ever:
(a) Refused to renew / cancelled or terminated a policy	Yes No

If YES, please give details below:

(b) Refused a claim or required an increased premium under the policy?

Yes No

If YES, please give details below:

(c) Imposed special conditions under the policy?

Yes No

If YES, please give details below:

(d) Have you been convicted on any criminal offence or been declared bankrupt?

Yes No

If YES, please give details below:

(e) Have you had any claims in the past 5 Years?

Yes No

If YES, please give details below:

Property
Address of Property		Postcode
Construction Walls		Roof
Floors		Age Yrs
Details of Security
Deadlocks	Yes No	Bars	Yes No
Bollards	Yes No	Fencing	Yes No
Shutters	Yes No	Window Film	Yes No
Alarm Type None Local Monitored Dialer Securitel
Fire Protection
Smoke Detectors	Yes No	Extinguishers	Yes No
Fire Hose Reels	Yes No	Smoke Detectors attached to Alarm System	Yes No
Property
Building		Stock including work in progress
Customers Goods		All other Contents
Accidental Damage
General Property
Cover Base Cover (Fire, Collision, Theft from Locked Vehicle / Building) OR Accidental Damage
Items ( Specify any Items Individually with a value over $1,000)




LIABILITY SECTION 1 - Public & Products Liability
Limit of indemnity $5,000,000 $10,000,000 $20,000,000

Do you do any Hot Work or Welding

Yes No

If yes then provide details of work done & % of income.

Does your business operate or visit any potentially high risk areas? (Such as Airports, Mining or Exploration Sites, Wineries, Petroleum Plants)

Yes No

If yes then provide details of work done & % of income.

Annual estimated turnover (sales)
Employees wages		Number of Employees
Proprietors/Directors wages		Number of Proprietors/Directors
Number of people in business at any one time

Does business engage sub contractors?

Yes No

Estimated total value of sub contractors
Labour Only	Labour & Plant	Labour, Plant & Materials
Type of work sub contracted to others

Are unregistered vehicles used in business?

Yes No

If yes, state details

Is cover required for Goods in Physical & Legal Control?

Yes No

If yes, state type of goods and amount of cover required

Previous losses/claims for Public Liability:
Excess Option $250 $500 $1,000

Your Duty of Disclosure and Utmost Good Faith
I have read the Duty of Disclosure (view)
Duty of Disclosure In order to make an informed assessment of the risk and calculate the appropriate premium, your insurer needs information about the risk you are asking it to insure. For this reason, before you enter into a contract of insurance, you have a duty under the Insurance Contracts Act 1984 to disclose to your insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer’s decision whether to accept the risk and, if so, on what terms. The duty also applies when you renew, extend, vary or reinstate a contract of insurance. You do not have to disclose anything that: Reduces the risk to be undertaken by the insurer; Is common knowledge; Your insurer knows, or in the ordinary course of its business, ought to know; or If the insurer has waived your obligation to disclose. If you do not comply with your duty of disclosure, your insurer may be entitled to reduce its liability in respect of a claim or may cancel your contract of insurance. If the non-disclosure was fraudulent, the insurer may be able to avoid (or cancel) the contract of insurance from its beginning. This would have the effect that you were never insured. One important matter to be disclosed is the history of losses suffered by the person seeking insurance or any closely associated person or entity. As you are responsible for checking that you have made complete disclosure, we suggest that you keep an up to date record of all such losses and claims.

Member of National Insurance Brokers Association and Steadfast Group Limited

Australian Financial Services Licence No 237491 – General Insurance Broker

Affiliations