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Professionals Office Plan
Office Package Insurance
Contact Details
Name*
Company
Address*
Phone* Fax
Email* Date of Birth*
* required      
 
Material Damage Insurance
Situation of Risk
Office Contents Sum Insured
Portable Tools of Trade
 (items of $5000 in value)
Professional Installed Burglar Alarm?     Yes No
Commercial Building
Replacement Value
Indemnity Value
Year Built
Construction
Gross Rent Income
  
 
Business Interruption Insurance
Loss of Profits (Annual Gross Profits)
Additional Costs of Working
Reinstatement of Accounts & Documents
Irrecoverable Book Debts
Claims Preparation Costs
Indemnity Period
   
 
Public Liability Insurance
Limit of Indemnity Required
Brief details of work performed
   

Motor Vehicle Details
  Vehicle 1 Vehicle 2
Year
Make
Model
Registration

Market Value

 
Have any modifications been made to the above vehicles?
Yes No
Has any driver been convicted of a driving offence?
Yes No
Have any drivers been involved in an at fault accident?
Yes No

How do you wish to receive your quote?

Please note
this form is for the quotation purposes only. All quotes are subject to the completion of the Insurer's proposal form and acceptance.
 
  
 
 
 

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