Contact Details
Name *
Company
Phone Number
E-mail Address *
Property Details
Business Street Address
Suburb
State
Please select state
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Occupation
Please select occupation
Hairdresser (no beauty treatments given)
Hairdresser (including beauty treatments)
Beauty Therapist
Turnover
Holding Insurer
Please select previous insurer
CGU
QBE
Allianz
Vero
Zurich
Other
No previous insurance
Start up business (less than 3 months old)
Due Date:
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1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2007
2008
Property Sum Insured
Construction
Please select
Brick/Concrete with sprinklers
Brick/Concrete no sprinklers
Timber with sprinklers
Timber with no sprinklers
Security
Please select
Deadlocks no alarm
Deadlocks with back to base alarm (unsecured line)
Deadlocks with back to base alarm (secured line)
Deadlocks with local alarm only (bells)
Deadlocks with dedicated line/securetel or GSM back up
No security present
Shopping centre with 24 hour security
Locality
Please select
Main Street
Suburban Street
Shopping centre (locked overnight and sprinklered)
Shopping Mall
Property Damage Sum Insured
Building
Contents
Stock
Other
Theft Sum Insured
Contents/Stock
Excess
$0
$100
$250
$500
$750
$1000
$2000
$5000
$7500
Other
Money Sum Insured
Transit/Business Hours
Safe
Glass
Yes
No
Business Interruption
Cover Type
Please select
Gross Income
Weekly Benefit
Indemnity Period
Please select
6 months
12 months
18 months
24 months
Sum Insured
Interruption
Accounts Receivable
Additional Increased Cost of Working
Liability Sum Insured
Public Liability
Please select
$5,000,000
$10,000,000
$15,000,000
$20,000,000
Products Liability
Please select
$5,000,000
$10,000,000
$15,000,000
$20,000,000
Care Custody and Control
Auto cover for $200,000
Excess
$250
$500
$750
$1000
$2000
$5000
$7500
