Rotary Club RNL Questionnaire 2025-2026

  • Rotary Club RNL Questionnaire 2025-2026

  • Rotary Club Insurance & Compliance Declaration 2025-2026
    To be completed by each individual club

    PLEASE COMPLETE AND SUBMIT AS SOON AS POSSIBLE BUT NO LATER THAN FRIDAY 11 APRIL 2025.

    IMPORTANT - Please read all Statutory & Important Notices prior to commencing Questionnaire.

    Aon Risk Services Australia Limited
    ACN 000 434 720

    175 Eagle Street
                                     Brisbane Qld 4000

  • Introduction & Guidance Notes

    Introduction

    Aon Risk Services Australia Limited (Aon) and Rotary have worked in conjunction to produce this 2025/2026 Insurance Renewal Declaration via Jotform to facilitate the provision of updated / current underwriting data. This will assist Rotary Clubs to discharge the disclosure obligations under the Group Insurance Program and to negotiate renewal of the program for the insurance period commencing 30 June 2025.

    Please complete every question in this questionnaire, including Nil or N/A where appropriate. Questions or parts of questions left blank will require further clarification.

    Format

    When you have completed the questionnaire:
    1. A copy of the questionnaire will be send to you via Jotform to your nominated email address.
    2. Print or save a copy of the completed questionnaire for your records.
    3. An E-mail of the completed questionnaire will be sent to your District Insurance Officer.

    For assistance with any aspect of this questionnaire, please contact your District Insurance Officer - contact details on Declaration Tab.

    Notes on Completion

    All figures should be based on either your latest 2024/2025 financials or your 2025/2026 budget estimates. These amounts will be used in part to determine premium allocations; adjustments will not be allowed once the renewal has been bound with the Insurer.

    If any question or section is not relevant to your operations, please mark clearly "Not Applicable". Questions or parts of questions left blank will need clarification.

    Questionnaire Deadline

    We would appreciate if you could return your completed Questionnaire and applicable proposal forms to your District Insurance Officer no later than Friday 11 April 2025.

  • General information

  • Rows

  • Protection

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  • Rotary Property Asset Schedule for the 2024-2025 Renewal Period

    1. Please Note: If your Club has a combined Assets and Revenue total Sum Insured of more than $50,000 please complete the below table.
    2. The $50k automatic cover is only for Clubs.  If the Club has other entities running a business or Op Shop, Second hand book shop, canteen/cafe etc. they need to advise all their assets below regardless of the amount.
    3. The declared sums insured are expected to reflect the cost to rebuild and replace the building and equipment in a new condition allowing for current designs and regulations.
    4. *Gross Revenue refers to the amount of sales or revenue generated from Rotary Op Shops & the like at each location
    5. ** Only applicable for example for Op Shops and the like.

  • Please use the keys below and enter the corresponding letter in the table for:

    Construction keys for floors, walls and roof:

    W = Wood, C = Concrete, CI = Concrete/Iron, M = Mixed, B = Brick, O = Other, T = Tile, Met = Metal

    Security keys

    K = Key Windows/Deadlock Doors, L = Local Alarm, B = Back to Base, P = Security Patrol, N = Night Guard

    Fire Protection

    HR = Hose Reel. EX = Extinguishers. T = Thermal Detectors. LA = Local Alarm. B = Back to Base. S = Sprinklered

  • Motor Vehicle Fleet

  • Categories

    1. BBQ Trailers / Trailers / Caravans / Food Vans (UP TO $9,999) to be included in the blanket cover category
    2. BBQ Trailers / Trailers / Caravans / Food Vans (From $10,000) – Sum Insured is required to be advised use the Over $10K category
    3. All other Motor Vehicles - sedans, vans, 4WD, tractors, utes, mini buses etc., use the market value category

  • Commercial travel

  • Description of Cover: Cover under the Policy applies whilst on authorised business or activities of the Policyholder including direct travel to and from such business/activities and also whilst on a Journey as defined if such Journey has been approved by Rotary.

    Journey Definition

    All Categories: Journey means the trip undertaken on the business of the Policyholder and/or authorized by the Policyholder, provided such travel involves a destination of 50 kilometres or more from the Covered Person’s normal place of business or residence and does not include normal daily travel between residence and place of business. Cover shall commence from the time a Covered Person leaves their normal place of residence or place of business, whichever is left last and continues on a full time 24 hour basis until they return to their normal place of residence or place of business, whichever occurs first. The maximum duration of any one trip is 90 days.

    Private Leisure Travel Definition

    Private Leisure Travel Definition: Incidental Private Travel means travel which is private and taken either side of or during an authorised Rotary trip to a maximum of 21 days (The purpose of the overall Trip being predominately for the benefit of Rotary)

  • 1. Estimated Travel

  • Please provide details of all trips for the twelve months commencing 30 June 2024 and the estimated trips for 2025-2026:
     
    This includes trips by your members that hold district positions - e.g. The District Governors trips to be included in his clubs travel figures.
     
    NB: Each person travelling counts as one trip. A return trip is counted as one trip (except for unscheduled flights – as noted below).

    • Trips for RAWCS and ROMAC should not be included in the figures below as they are provided to Aon separately
    • Please ensure you are including trip numbers for Members / Volunteers / Participants / Scholarships / Short Term Youth Exchange Students less than 3 months
    • A road trip that does not include an overnight stay (where there is no accommodation or loss of deposits) is not to be counted as a trip.  

  • Declared Trips

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  • 2. Sanctions

  • 3. Non-scheduled Flights

    Means travel in an aircraft whose flights are not conducted in accordance with fixed flying schedules, over specific air routes, to and from fixed terminals.

  • Note: 1 person traveling return = 2 flights. This table relate to flights both domestic and international - please complete if answered yes

  • Rows
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  • Op Shop Renewal Questionnaire Form

  • General

  • Compliance and Legislation

  • Transit Insurance

  • The Transit cover under the Property policy is for when you are moving premises and will only apply during the incidental movement of such property within Situations occupied by the Insured and is not for shipping of DIK and/or other goods.

    Separate Marine Transit cover is required for Inland and Export transits for Projects and/or Donations in Kind consisting of goods such as:
    1. Bicycles, Hospital Beds, Dentists Chairs, Furniture, Books, Charitable Merchandise, Clothing, and Blankets, Household Goods/Personal Property and Recycled Playgrounds.
    2. Hardware and Building Materials (Excluding Tiles/Stone Benchtops/Solar Panels)
    3. Instruments (Scientific/Laboratory/Medical) Used X-ray machines, Ultrasound machines, Hospital Beds, gloves, gowns, bandages and the like.
    **If applicable to your Club, we require you to complete the below.**

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  • Excluded Countries

    Unless specifically noted on the policy schedule; cover is excluded for transits (including transhipments) to and/or from and/or within and/or through countries on the Excluded

    countries list:

    Afghanistan, Algeria, Belarus, Bolivia, Central African Republic, Chad, Colombia, Congo-Kinshasa (DRC), Cote d'Ivoire (Ivory Coast), Cuba, Egypt, Ethiopia, Guinea, Iran, Iraq, Israel, Jordan, Kenya, Democratic People's Republic of Korea, Lebanon, Libya, Madagascar, Mali, Myanmar, Nigeria, Pakistan, Palestinian Authority (Gaza And West Bank), Russia, Russian North Caucasus region (Chechnya, Dagestan, Ingushetia, Kabardino-Balkaria, Karachay-Cherkessia, Ossetia - North and South), Somalia, Sudan, South Sudan, Syria, Ukraine (including the Sea of Azov), Venezuela, Yemen, Zimbabwe

  • Statutory Notices

  • Declaration

  • Please read and complete the declaration below:

    1. I declare that the particulars provided in response to the questions contained in this Renewal Declaration are true and correct, and I have discharged my duty of disclosure.
    2. I have not suppressed, misrepresented or misstated any relevant fact.
    3. I agree that the particulars provided shall be the basis of the contract of insurance and be deemed to be incorporated in the policies to be issued.
    4. I confirm that I have read and understood the "Statutory & Other Important Notices" section of this declaration
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  • If you have any queries or require assistance, please contact your District Insurance Officer (DIO):

    District  Contact Name  Contact No.  Email
    9423 Steve Halbert 0414 974 234 dio@rotarywa.au
    9510 John Rix 0474 053 562 johnrix@riverland.net.au
    9560  Col Craig 0458 741 536 insurance@rotary9560.org
    9620  Tony Sykes 0412 311 871 insurance@rotary9620.org
    9620 Subhashni Singh 0406 764 113 msubhashni_ss@hotmail.com
    9640  John Giuricin 0419 303 050 insurance@rotary9640.org
    9660  Brett White 0427 659 606 brett@trubrett.com.au
    9675  Joanne Glaser 0418 227 812 joanne.glaser@hotmail.com
    9685  Dallas Booth 0412 445 454 dallaswbooth@live.com
    9705  Ian Wholohan 0427 939 786 insurance@rotary9705.au
    9780 Don Shields 0419 390 303 don@gibvic.com.au
    9790 David McPherson 0408 629 644 dmcpherson2710@gmail.com
    9800 Mark Perree 0412 707 701 insurance@rotary9800.org
    9815 Marcus Robertson 0414 184 179 insurance2@rotary9815.org.au
    9815 Phil Thurgood 03 9767 5111 phil@tttinsurance.com.au
    9830 Bruce House 0487 310 100 bruce@tasib.com.au

    A copy of this questionnaire will be sent to your email and your DIO.


    Thank you for completing the Renewal Questionnaire.

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