Quotation Slip
Commercial Strata
EMAIL COMPLETED SLIP HERE
Agent/Broker/Lot Owner
Date
Phone
Name
Email
Mobile
Insured/Strata Plan Number/ Unit Plan Number
Scheme Name
Mailing Address
Suburb
State
Postcode
Property Address
Suburb
State
Postcode
INSURANCE DETAILS
Current Insurer
Excess(es) $
Policy Due Date
Has Renewal Been Offered?
Yes
No - Please specify reason
Has Insurance Been Declined Or An Excess Imposed?
No
Insurer Claim For Last 3 Years
Total Premium $
No
Yes - Please Specify
Yes - Please attach claims history
BUILDING INFORMATION
Year Built
Occupied
No. of Units
Yes
No
Partially - Please specify approx % occupied
No
Any Building or Common Property Defects?
Walls
Other - Specify
Floors
Other - Specify
Fire Sprinklers Installed
No. of Storeys
Yes, All Floors
Are Any lots occupied for Residential Purposes
No
No
No. of Basements
Yes - Please attach report(s)
Roof
No
Yes
Heritage Listed
No. of Buildings
Other - Specify
Yes, Partially - Please Specify
Yes - Please specify number of lots
Please list all Commercial Occupants
BUILDING FACILITIES
No. of Lifts
Are Onsite Services Provided?
Other Facilities – Please specify
No
Yes – Please specify
POLICY VALUES
Building Sum Insured (BSI)
$
Catastrophe (15% or 30% of BSI)
Common Area Contents
$
Workers Compensation
Yes
No
Office Bearers Liability
$
Optional Flood Cover
Yes
No
Public Liability
$
Optional Paint Benefit (NSW/ACT only)
Yes
No
Machinery Breakdown*
$
$
*Please provide a list of Machinery items
AUTOMATIC POLICY INCLUSIONS
103481 - 09/15
15% Loss of Rent, Voluntary Workers, Fidelity Guarantee, Government Audit Costs & Legal Expenses and Lot Owners Fixtures & Improvements
CHU Underwriting Agencies Pty Ltd ABN 18 001 580 070 (AFS License No: 243261) is an underwriting agency acting on behalf of the insurers: QBE Insurance (Australia) Limited ABN 78 003 191 135 (AFS License No 239545)