Air-Conditioning & Refrigeration Contractors Liability

We need to find out what you do before we can quote.

You have two options:

  • Call 1300 881 779 during business hours for a quote over the phone, or

  • Complete this form and we will email you a quote

 

Insured Details

If you have spoken to a broker in our office, note their name here so that this quote can be processed by them as they will know something about you already.

Brokers Name:

Insured Name

Trading Name

ABN No.(if known)

Full Address

Email Address

Website Address

Phone No. *

Trade Duties

What is your occupation:

Have you been in this trade or type of business for over 3 years?
Yes    No

Please provide Us with a full description of Your business activities.

Please provide percentage breakdown of activities:
% - Air conditioning
% - Refrigeration
% - Plumbing (Victoria)

% - Plumbing (Other States)
% - Other
Percentage breakdown by type of work undertaken:
% - Domestic

% - Commercial

% - Industrial

Cover Required

Please nominate the amount of cover you require:

Underwriting Questions

No. of full time employees:  

No. of part time employees:

What is your annual business turnover?
$

Does the business undertake work on large industrial sites?
Yes    No

If "NO" cover will be limited to domestic & light commercial work only.

Do you work on equipment other than split systems & ducted systems?
Yes    No

Is any cooling tower installation or maintenance carried out?
Yes    No

Do welding activities comply with the Australian Standard 1674.1-1997?
Yes    No

Do you perform any welding at abattoirs?
Yes    No

Perform work at mine sites, either above or below ground?
Yes    No

Provide products or services intended for use in the mining industry?
Yes    No

Provide equipment on hire?
Yes    No

Do you Import any products into Australia?
Yes    No

Do you Export any products to the USA or Canada?
Yes    No

Is the business involved in any of the following?

  • Wharf or any form of ship handling or loading facility
  • Aircraft, Airports, Airlines, Satellites, Space or Radar Installations
  • Public Utilities (eg Power Plants, Water Treatment, Communication)
  • Military Installations
  • Dams
  • High voltage power supply
  • Railways
  • Chemical Manufacturers
  • Oil and/or Gas Production
Yes    No

Contractors

Do you employ contractors or sub-contractors?
Yes    No

If you answered YES
Estimated annual payments to these contractors?
$

Do they have their own Public Liability cover?
Yes   No

Labour Hire

Do you use labour from labour hire companies?
Yes    No

 

Your History

Have you or anyone to be insured under this policy:

  • Had insurance cancelled or declined by an Insurer?
  • Had a proposal rejected, renewal refused or claim rejected by an Insurer?
  • Had any special conditions imposed?
  • Suffered a loss whether insured or not (last 5 years only)?
  • Been declared bankrupt or become insolvent?
  • Been charged or convicted for any criminal offence?
Yes    No


Type the above number:



Declaration

By submitting this Declaration, the Applicant acknowledges:
- they are authorised by all the Applicants to make this Declaration,
- the contents of this form are true and complete,
- they are under a continuing obligation to immediately inform the insurer of any change in the particulars or statements contained in this form up until the contract is entered into,

Name of person making this declaration: