CGIB Mobile Plant & Machinery, Truck, Motor Vehicle, Trailer, Public Liability and Tools Quote Online Form

CGIB Mobile Plant & Machinery, Truck, Motor Vehicle, Trailer, Public Liability and Tools Quote Online Form
Please complete the following information and submit this form to obtain an insurance quotation for your business.

All information you provide must be correct, true, and accurate as incorrect or misleading information may alter our quote and jeopardise cover if you proceed with a policy.

Please ensure you read the CGIB Customer Information Page before filling out this form. This includes essential documents such as our Financial Services Guide, General Advice Warning, Privacy Statement, and Duty of Disclosure.

If you are having any issues completing this form please contact our office on: 1300 764 244 or 03 8841 4200 and one of our Team will be able to assist you.
INSURED'S Details
Insured Full Name*
Business Name (If applicable)
ABN Number
Number of Employees*
Number of years operating this business*
INSURANCE Details
Mobile Plant & Machinery, Truck, Motor Vehicle, Trailers

IMPORTANT: Un-Registered Items Cover will exclude damage to third party property or third party injury caused by the item / machine. RECOMMENDATION: Obtain a Public Liability Insurance Policy.
Items Requiring Cover

Please list all items that require cover, include details and the value of any attachments, Trailers also need to be included. For larger fleets (over 5 etc) you can also upload your own list (below the table).
Item List*
For over 10 Items, please upload you own list

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Driver/s / Operators Details - (Please add additional Driver / Operators and the listed items they use from your item list) *
Garaging / Storage Address *
Usage
Are these item/s used for business or private use?*
What is your occupation *
If selected "Private use" please advise land size in acres *
Fully describe what the vehicle / truck / machinery / plant / trailer, will be used for*
How many years experience do you have operating this type of machinery or similar equipment*
Do you currently (or recently) have truck insurance? (years held) *
Do you currently (or recently) have machinery insurance? (years held)*
Is the vehicle / truck / machinery / plant / trailer, involved in work at locations above the 26th degree parallel in Western Australia or Northern Territory?*

YesNo
Do you allow sub-contractors to drive or operate your vehicle / truck / machinery / plant / trailer*

YesNo
Please provide specific details*
Is your vehicle / truck / machinery / plant / trailer, let out on a Dry Hire basis (i.e. without you or your employee being in charge)?*

YesNo
Please note:

Damage Waiver/Extended Dry Hire
The typical machinery insurance policy does not include damage waiver cover (extended dry hire) as a standard cover, however it can be added as an optional extra. Here is how it works:

No Damage Waiver Cover: (what happens if your client damages your machine?):
If your client (the person hiring the item) damages your item, they are now responsible for those damages. Usually in this case the insurer will pay for these damages but they will then attempt to recover their costs from your client as they were responsible. It is recommended that your client should have insurance in place for the item/s they are renting from you.

With Damage Waiver Cover: (what happens if you offer to insure the machine for your client):
If you include a Damage Waiver into your hire agreement and charge your client a fee for this, the insurer will not seek to recover any costs from your client if they cause damage to the item. However, it is important to note that this coverage typically comes with an extra premium and any claims may impact your claims history and premiums in the future.

This cover is an optional extra that needs to be added to your policy, therefore you must notify us immediately if required.

Note: If you can't upload a copy to this form please email a copy of your hire agreement to : cgib@cgib.com.au
Please upload a copy of your Hire Agreement

File types accepted: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Does your Hire Agreement offer a Damage Waiver?*

YesNo
Is any of the items being insured used or expected to be used in any of the following activities:*

On, in, over or under a permanent body of water?Sand or beach operations?A tidal zone?Floating platforms or barges?Irrigation systems, canals, reservoir, filled dam/s or siphon work?Demolition greater than 15m in height?Exploration, dangerous gases, work in oil?Chemical/ petrochemical plants or other dangerous occupations?Underground works tunnelling, shafts or galleries excavation deeper than 10m?Blasting or explosives?Directional drilling or boring greater than 1m in diameter?Airport/aircraft landing area, railways, tramlines or on road works or bridges?None of these
If "YES" to any of the above, please provide specific details*
PUBLIC LIABILITY

For amounts you become legally liable to pay as compensation for Personal injury or Property Damage as a direct result of an occurrence happening in connection with your business subject to the Insurers PDS/Policy Wording
Please see our short video on Public & Products Liability Insurance for further infomation.
Liability Cover Required?*
Fully describe all the products and/or services your business provides*
Sum Insured Required?*
Do you employ sub contractors? *
Annual payments to sub / contractors*
Do you use labour Hire?*
Annual payments to Labour Hire*
Annual Business Turnover*
Do your operations include any of the following?
Work at airports, railway, oilrigs, gas rigs, oil refineries, chemical refineries, mines or quarries, ship yards?*

YesNo
Work with/on cooling towers, alarm systems or mainframe computers?*

YesNo
Boilers and/or compressors which require Government certificates?*

YesNo
Manufacture, distribution, storage, transportation, of chemicals or other toxic or harmful matter?*

YesNo
Use or storage of explosives?*

YesNo
Provide any advice, design or professional services, whether or not a fee is charged for such advice, design or professional service?*

YesNo
If yes to any of the above, please provide details*
TOOLS

Covers the insured property anywhere in Australia - subject to the Insurers PDS/Policy Wording
Portable Items Cover Required?*
At least one of the questions below must be answered. Use 0 if not required
Specified Portable Items
Unspecified Tools / business equipment (total amount for all items with an individual value below $ 2,500)*
Sum insured amount required for Stock*
PREVIOUS INSURANCE Details
Do you currently hold an insurance policy?*
Please provide the date your existing policy expires *

DayMonthYear
Date
Please select the name of the Insurer*
Provide existing insurer name*
Have you, or anyone who will operate any of your Vehicles or Machinery:
1. Ever suffered any losses or claims in the last 5 years?*

YesNo
2. Had any motor insurance policies or claims refused or cancelled or special terms imposed in the last 5 years?*

YesNo
3. Been involved in a company or business which became insolvent or subject to any form of insolvency or voluntary administration (e.g liquidation or receivership)?*

YesNo
4. Ever been charged or convicted of any criminal offence including driving under the influence of alcohol or drugs (DUI), had a licence suspended or cancelled or been convicted of a total of more than 2 traffic offences (excluding parking) in the last 5 Years?*

YesNo
5. Are you aware of any matters not disclosed above that is relevant to the underwriters consideration of this insurance?*

YesNo
Please provide all relevant information to all questions answered "Yes"*
CONTACT Details
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Postal Address*

Street Address

Street Address Line 2

CityState

Post Code
Postal code search*
How did you find us?*
Please provide details
Comments / Additional Information
IMPORTANT INFO
By proceeding you agree to the Terms of Use of this site and that you have read and understood this Important Information about answering questions that we ask of you.
We will handle your personal information in accordance with our Privacy Policy.

Completion of this form does not put an insurance policy/cover in place - you will need to contact us to arrange insurance cover.
Other Insurance Needs
Do you require any further information on other insurances?

Office InsuranceManagement LiabilityLandlords CommercialLandlords ResidentialCyberHome & ContentsTravelConstruction & Public Liability
* Mandatory Fields

Thank you for completing our online form.
We will endevour to contact you with your insurance details soon.
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CGIB Mobile Plant & Machinery, Truck, Motor Vehicle, Trailer, Public Liability and Tools Quote Online Form

INSURED'S Details

INSURANCE Details

Mobile Plant & Machinery, Truck, Motor Vehicle, Trailers

Items Requiring Cover

Usage

PUBLIC LIABILITY

TOOLS

At least one of the questions below must be answered. Use 0 if not required

PREVIOUS INSURANCE Details

Have you, or anyone who will operate any of your Vehicles or Machinery:

CONTACT Details

IMPORTANT INFO

Other Insurance Needs