Commercial Strata

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Policy details
Policy period
Form*
MM slash DD slash YYYY
To*
MM slash DD slash YYYY
Who are you insured with*
Insured details
Insured name*
First Last
Email*
Phone
Contact name*
Address
Street Address Address Line 2 City State Postcode Country
CLAIMS HISTORY
Claims details (Within past 5 years)
Have you during the past 5 years had any insurance declined or any underwriting conditions or excesses imposed?
- Yes
- No
Have you had any claims in the past 5 years?*
- Yes
- No
Policy Cover
Sum Insured
Building(s) at the above situations*
Loss of rent / temp. accommodation
Common area contents
Legal liability's*
Voluntary Workers
Workers compensation
Do you want to cover employees?
- Yes
- No
Fidelity guarantee
Office bearers liability
Machinery breakdown
Building catastrophe
Extended cover - rent / temp. accommodation
Escalation in cost of temp. accommodation
Storage / evacuation
Government audit costs
Appeal expenses - common property health and safety breach
Legal defence expenses
Lot owners
Questionnaire
Building
Internal Walls (between' units)*
External Walls*
Floors*
Roof*
Fences built of*
Year built*
Street Number Type*
Street Number*
Street Name*
Street Type*
No. of unite*
No. of storeys*
Heritage listed?
- Yes
- No
Is the Building maintained to a good standard of repair?
- Yes
- No
Is the Building occupied?
Please provide the percentage occupied*
Is any part of the Building used for domestic purposes?
- Yes
- No
Please provide percentage. used for domestic purposes*
Do any of the Building's occupants have commercial cooking facilities?
- Yes
- No
Please select occupancy type(s)
- Offices
- Retail shops
- Industrial
Note It is your duty to advise us of any chanegs in the occupations carried on at the risk location.
Unit State Oooupanoy

Note It is your duty to advise us of any chanegs in the occupations carried on at the risk location.
Are there any air-conditioners or electric motors in excess of Skw?
- Yes
- No
Do you want cover against breakdown?
- Yes
- No
Please Indicate the faceless provided by your Strata:
- Lifts
- Spas
- Pools
- Tennis Courts
- Other
Do you have a strata manager?
- Yes
- No
Is the insured registered for GST?
- Yes
- No
To what extent is the insured entitled to claim input tax credits?*
Please write the Australian Business Number (ABN) here*
Signature
This electronic signature will be treated the same as if signed personally.*
This is signature..
Name

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Commercial Strata

Commercial Strata

Policy details

Policy period

Insured details

CLAIMS HISTORY

Policy Cover

Questionnaire

Signature

Insurance Quote

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Unit	State Oooupanoy