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- Construction Material of the Walls?*
- Construction Material of the Floors?*
- Construction Material of the Roof?*
- Sandwich Paneling?*
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- Premises Equipped with a Sprinkler System*
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- Is the Premises Equipped with any of the following*
- Is the Premises Equipped with any of the following*
- Premises Connected to Town Water?*
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- Is the Building Heritage Listed?*
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- Do you or any of your tenants, to your knowledge, sell tobacco products, e-cigarette products, or any other tobacco or nicotine related products?*
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- Does the business activities involve cooking?*
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- Limit any one loss*
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- 1. Has the insured or any director or partner involved with the business or any other business experienced any claims or are aware of any circumstances including regulatory investigations that could give rise to a claim that may have been covered by this policy?*
- 2. Has the insured or any director or partner involved with the business or any other business have in the past 5 years ever been convicted of an offence relating to the Health and Safety of their employees or members of the public in connection with their business?*
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- Ever had any insurance cancelled or declined or special terms imposed?*
- Ever been declared bankrupt?*
- 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)?*
- Been convicted of any criminal offence within the past 5 years (other than minor traffic convictions)?*
- Been liable for a civil offence or pecuniary penalty (exceeding $5,000)?*
- Aware of any matters not disclosed above that is relevant to the underwriters consideration of this insurance?*
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Format: 0000 000 000.
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- Do you require any further information on other insurances?
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- Should be Empty: