Commercial Property Insurance - High Street Underwriting Agency

Quote Form for Commercial Property Insurance - Burglary/Theft, Building, building, Contents, Consequential Loss, Glass, Stock, Money Insurance Coverage

Insurance for Australians - Public Liability & Indemnity for the Retail Punlic, the Mining Industry, Equine Activities and General Insurance Brokers offered byHigh Street Underwriting Agency, Brisbane Australia

Retail Public Liability and Indemnity Insurance

Commercial Property - On-Line Quote Form

For a COMMERCIAL PROPERTY INSURANCE quotation, please complete the ON-LINE FORM below and click on SUBMIT.

ON-LINE QUOTE QUESTIONNAIRE FORM

CLICK HERE FOR A PRINTER FRIENDLY VERSION TO FAX

CONTACT DETAILS

BUSINESS NAME:
PHONE NO.:
FAX NO.:
CONTACT PERSON:
EMAIL ADDRESS:
WEB SITE ADDRESS:

BUSINESS DETAILS

BUSINESS DESCRIPTION:

NUMBER OF YEARS EXPERIENCE
IN THIS INDUSTRY:

ESTIMATED ANNUAL TURNOVER
FOR THE NEXT 12 MONTHS:

DO YOU OPERATE AND/OR
EXPORT TO THE USA &/OR CANADA:

YES

HAVE YOU HAD ANY CLAIMS
IN THE LAST 3 YEARS?:

YES

DO YOU PROVIDE OTHER ACTIVITIES
NOT USUAL TO YOUR INDUSTRY?:

YES

IF YES, PLEASE DESCRIBE:

THE PROPERTY

SITUATION OF
PROPERTY(ies) TO BE INSURED:
CONSTRUCTION. AGE.

IF BUILT BEFORE 1981,
LAST REWIRED, LAST ROOF INSPECTION

BUILDING $:

CONTENTS (INCLUDING STOCK) $:

CONSEQUENTIAL LOSS $:

EXCESS $:

GROSS PROFITS $:

BURGLARY THEFT

CONTENTS $:

STOCK $:
(Excl. cigarettes/tobacco & liquor/alcohol)

STOCK OF CIGARETTES / TOBACCO $:

STOCK OF LIQUOR/ALCOHOL $:

ANY SECURITY - DEADLOCKS, ALARMS, etc:

MONEY

TRANSIT:

BUSINESS HOURS:

LOCKED SAFE:

PERSONAL CUSTODY:

GLASS

IS COVER FOR INTERNAL & EXTERNAL
GLASS REQQUIRED?:

YES

AMOUNT OF LIABILITY COVER REQUIRED:
($10,000,000 recommended)

THANK YOU!