Construction and Liability (Annual Blanket) Insurance Quote Online Form

Construction and Liability (Annual Blanket) Insurance Quote Online Form
Please complete the following information and submit this form to obtain an insurance quotation for annual (multi projects) construction and liability insurance.

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.

Please see our helpful video for further information

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
Business Name/Insured*
ABN Number*
Business Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Postal code search*
Number Of years experience in the Building Industry*
Builders Licence details *
Number Of Employees *
Do you employ sub / contractors*
Annual Payments to sub / contractors*
Do you use labour hire*
Annual payments to labour hire*
BUILDING Activities
Business Occupation*
Total must equal 100%
Building Residential: New
Building Residential: Structural Alteration/Additions
Building Office/Commercial: New
Building Office/Commercial: Structural Alterations/Additions
Building Industrial: New
Building Industrial: Structural Alterations/Additions
Building Non-Structural: Refurb Fitout/Alterations
Other
Percentage for other
Maximum Number of Storeys*
Maximum Number of Basement Levels*
Will any project involve any of the following? (select all that apply)

1. Blasting or explosives2. Actual excavation work or work in an existing excavation deeper than 10 metres3. Underground works such as tunnels, shafts, mines or galleries4. Road works or bridges5. Work north of the 25th Parallel6. Pipelines greater than 250 metres in length7. Excavation of Underground services on site (other than to install new services)8. Directional (horizontal) drilling or boring greater than 1 metre in diameter (other than piling / piers)9. Work in or around an airport or aircraft landing area or working railways or tramlines10. Work in oil, gas, chemical or petrochemical plants, including any work on gasline service stations11. Work in mining processing plants12. Technology which is of prototype nature13. Work on landfills, land which is listed on the contaminated land register or application of waste or chemical products to land14. Design and construct where you will provide the design15. National Heritage or Historic Listed16. Swimming pools where such works are greater than 30% of the contract value17. Any works in, under or over water18. Any works involved in the power industry19. Any demolition exceeding 15 metres in height or exceeding 25% of your annual turnover20. The lending of a Builder's Licence to or by you21. None of the above apply
Please provide the corresponding question number and all relevant information to all questions answered "Yes"
Location of your projects
Total (must equal 100%)
NSW
VIC
QLD
SA
WA
TAS
ACT
NT
Other
Percentage of Other
INSURANCE Details

Please provide an estimate
Total of all contract values of all projects, to commence within the next 12 months*
Estimated Turnover
The largest contract value any one project*
Maximum construction period any one project*

6 Months12 Months18 Months24 MonthsGreater than 24 Months (Please specify)
Public Liability*

Not Required$10,000.000$20,000,000$50,000,000Other, please specify
Pre-Existing Structures*
Maximum Replacement / Reinstatement Cost any one Pre-Existing Structure**
Number of projects which involve a Pre-Existing Structure*
Employee Tools*
Total Sum Insured (Employee Tools)*
Tools and Equipment (other than Mobile Plant and Equipment)*
Total Sum Insured (Tools & Equipment)*
Mobile Plant and Equipment*
Total Sum Insured (Mobile Plant & Equipment)*
Display Homes *
Current Projects under Construction and not completed*
Project list *
Hired In Mobile Machinery and Equipment*
Total Annual Hire Costs**
Maximum Replacement Value of Hired Equipment at any one time*
Cover for Items and Materials provided by the Principal or Owner*
Maximum Value of Items supplied*
Pollution Liability*
Contractual Liability*
PREVIOUS INSURANCE Details
Do you currently hold an Insurance Policy?*

360 ConstructMeconChase UnderwritingSURA ConstructionNo, I am not currently insuredOther
Type of cover *
Please provide the date your existing policy expires*

DayMonthYear
Date
If No cover was selected, please explain further*
Have you ever suffered any losses or claims?*

YesNo
Have you ever had any insurance cancelled or declined or special terms imposed?*

YesNo
Have you ever been charged or convicted of any criminal offence or declared bankrupt?*

YesNo
Been associated in any way with any: Outlaw Motorcycle Gang ("OMG") or any member of an OMG; Organised Crime Gang ("OCG") or any member of an OCG, or other illegal association?*

YesNo
Had a liquidator and/or receiver appointed and/or been placed into external administration?*

YesNo
Been a defendant in any civil court case?*

YesNo
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". Please include where applicable, dates, insurance companies, amounts claimed,and other information that may be relevant to the consideration of this insurance.:*
CONTACT Details
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: 0000 000 000.
Email*
example@example.com
Is the Business address the same as the Postal Address
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 ResidentialPublic LiabilityCyberMotor VehicleHome & ContentsMachinery & PlantTravelTrades InsuranceOther
* Mandatory Fields

Thank you for completing our online form.
We will endevour to contact you with your insurance details soon.
Should be Empty:

Construction and Liability (Annual Blanket) Insurance Quote Online Form

INSURED'S Details

BUILDING Activities

INSURANCE Details

PREVIOUS INSURANCE Details

CONTACT Details

IMPORTANT INFO

Other Insurance Needs