Commercial Strata

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Policy details
Policy period
Form*
To*
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
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