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Hamilton Brokers Body Corp Insurance Quote Form
Your Name
(*)
Please let us know your name.
Your Email
(*)
Please let us know your email address.
Insured Name
(*)
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Unit Plan Number
(*)
Please Select
CTS
SP
UP
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Professionally Managed
(*)
Please Select
Yes
No
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Building Use
(*)
Please Select
100% Residential
Commercial
Mixed Use
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Situation of Risk / Address
(*)
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Post Code
(*)
(*)
State
Please Select
ACT
NSW
VIC
TAS
SA
WA
NT
QLD
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Current Insurance Period
(*)
to
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Current Insurer
Please Select
ACE
AMP
ALLIANZ
CGU
SUU
SUNCORP
NRMA
GIO
ZURICH
Other
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Base Premium
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Excess
Please Select
$100
$250
$500
$1000
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Building Information
Year Built
(*)
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Type of Building
(*)
Please Select
Unit
Townhouse
Villa
Other
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Heritage Listed
(*)
Please Select
Yes
No
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Number of Units
(*)
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No of Levels
(*)
Please Select
1
2
3
4+
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Internal Walls
(*)
Please Select
Brick/Conc
Wood
Fibro
Other
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ExternalWalls
(*)
Please Select
Brick
Concrete
Hardiplank
Metal
Tilt Slab
Fibro / Asbestos
Glass
Green Board
EPS
Other
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Roof
(*)
Please Select
Concrete
Tile/Metal
Fibro
Other
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Floors
(*)
Please Select
Concrete All Levels
Concrete Ground
Timber
Tile
Slate
Other
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Is the property in good repair
(*)
Please Select
Yes
No
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Facitilies
(*)
Please Select
Yes
No
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Elevators
Pools
Spas
Gymnasium
Tennis Courts
Saunas
Movie Cinema
Restaurant/Cafe
Pontoons Marina
Water Features
Lake/Pond
Waterways
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Fire Protection
(*)
Please Select
Fully Sprinklered
Hose Reels & Extinguishers
Extinguishers Only
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Security
(*)
Please Select
Yes
No
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Security alarm
Security Access
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Owner Occupied
%
Permanent Living
%
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Unoccupied
%
Holiday Letting
%
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Cover Required
Section 1 Property
Building(s)
(*)
$
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Additional Benefits (paid in addition to building(s) sum insured)
Loss of Rent / Temporary Accommodation
%
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Common Contents
(*)
%
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Catastrophe
Please Select
Not Required
15%
30%
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Lot Owners Fixtures & Imporvements - Residential (per lot)
(*)
Please Select
Not Required
$250,000
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Lot Owners Fixtures & Imporvements - Commercial (per lot)
(*)
Please Select
Not Required
$250,000
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Section 2 Property Owners Legal Liability
Limit of Liability
(*)
Please Select
Not Required
$10,000,000
$20,000,000
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Section 3 Fidelity Gaurentee
Sum Insured
(*)
Please Select
Not Required
$10,000
$20,000
$40,000
$50,000
$100,000
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Section 4 Voluntary Workers Personal Accident
Capital Benefit
(*)
Please Select
Not Required
$50,000
$100,000
$200,000
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Weekly Benefit
(*)
Please Select
Not Required
$500
$1,000
$2,000
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Section 5 Office Bearer's Liability
Limit of Liability
(*)
Please Select
Not Required
$100,000
$1,000,000
$2,000,000
$5,000,000
$10,000,000
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Section 6 Machinery Breakdown
Machinery Breakdown
(*)
Please Select
Yes
No
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Option A - Motors Under 5Hp or 4Kw ($10,000 any one loss)
Number of units to be insured
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Option B - Motors Over 5Hp or 4Kw & Bolier & Pressure plant as listed below
Description
Sum Insured
Item 1
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Item 2
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Item 3
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Section 7 Legal Expenses (note: Legal Defence & Appeal Expenses)
Limit of Liability
(*)
Please Select
Not Required
$50,000
$100,000
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Section 8 Audit Expenses
Limit of Liability
(*)
Please Select
Not Required
$25,000
$50,000
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Claims
Have you had any claims in the past 5 years?
(*)
Please Select
Yes
No
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Date of Claim
Type of Claim
Amount
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Is This a Commerical Property
Please Select
Yes
No
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Occupancy - For Commercial Property Only
Tenant Name
Occupation / activity undertaken at location
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Notes
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Would you consider a higher excess to reduct premium?
(*)
Please Select
Yes
No
Please Select
$250
$500
$1000
$2000
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What is the most important aspect
Price
Coverage
Claim Response
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