Rotary Insurance Renewal Questionnaire 2026-2027

  • Rotary Insurance Renewal Questionnaire 2026-2027

  • Rotary Club Insurance & Compliance Declaration 2026-2027
    To be completed by each individual club

    PLEASE COMPLETE AND SUBMIT AS SOON AS POSSIBLE BUT NO LATER THAN SATURDAY 25 APRIL 2026.

    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 2026/2027 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 2026.

    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 2025/2026 financials or your 2026/2027 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 Saturday 25 April 2026.

  • 1.General information

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  • 1.6 Is your Club involved with youth, including any Rotary Youth Programs (e.g. RYLA,RYPEN, YEP) or any other youth‑related activities?*
  • 1.7  Does your Club comply with the Rotary International Policy and Certification for Youth Protection and the Prevention of Abuse and Harassment?*
  • 1.8 Does your Club maintain a register of Rotary Youth Volunteer Information and Declaration forms (for both Rotarians and non‑Rotarians) as required under Youth Protection compliance and procedures?*
  • 1.9 Has your Club provided copies of all Rotary Youth Volunteer Information and Declaration forms (for both Rotarians and non‑Rotarians) to the District for document retention, as required under Youth Protection compliance and procedures?*
  • 1.10 Has your Club ever received a complaint or allegation of sexual abuse or harassment from any source that has not been previously reported?*
  • 1.11 Is your Club aware of the reporting guidelines within the Rotary International Policy for Youth Protection and the Prevention of Abuse and Harassment?*
  • 1.12 Has your Club received training to comply with the Rotary International Policy and Certification for Youth Protection and the Prevention of Abuse and Harassment?*
  • 1.13 Does your Club require an update on complying with the Rotary International Policy and Certification for Youth Protection and the Prevention of Abuse and Harassment?*

  • 2. Rotary Property Asset Schedule for the 2026-2027 Renewal Period

    1. Please Note: If your Club has an asset sum insured of more than $50,000 please complete the below tables.
    2. The $50,000 automatic cover applies to Club assets only.  If the Club has other entities running a business or Op Shop, Second hand book shop, canteen/cafe etc. all assets must be declared below regardless of value.
    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. It is all the money your business brings in from sales before subtracting any costs or expenses - within a 12 month period
    5. Only applicable for example for Op Shops and the like.
    6. Please only list assets that your club actually owns.
  • 2.1.1 Does your Club have physical assets with a replacement value of more than $50,000?*
  • 2.2 Does your Club have other entities running an Op Shop or Thrift Shop,(If yes to Op Shop, please complete the Op Shop Questionnaire tab)*
  • 2.3 Does your Club have other entities running any other assets like a second hand book store, cafe, canteen etc.*
  • At how many locations do you you have physical assets with a replacement value of more than $50,000 or assets like Op shops, cafes etc?*

  • 2.3 Location 1- Property asset schedule

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  • 2.4 Location 2 - Property asset schedule

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  • 2.5 Location 3 - Property asset schedule

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  • 2.6 Location 4 - Property asset schedule

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  • 3. Motor Vehicle Fleet

  • Please note trailers (to be included even if not towed) are part of the motor vehicles to be insured - see categories below

  • 3.1 Are there any Motor Vehicles (including trailers) to be insured?*

  • Categories

    1. Up to $9,999
      • These vehicles are included in the Blanket Cover category
    2. From $10,000
      • A Sum Insured must be provided, and the Over $10,000 category must be used
    3. Sedans, Vans, 4WDs, Tractors, Utes, Minibuses, etc. – use the Market Value category.
      • Built in fixtures in food vans or BBQ trailers form part of the vehicle value.
      • Unattached contents are not covered under the Motor Policy and must be insured under Property Insurance.

  • 3.5 Blanket Cover Category (BBQ Trailers / Trailers / Caravans / Food Vans up to $9,999)

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  • 3.6 Over $10k category (BBQ Trailers / Trailers / Caravans / Food Vans $10k and over)

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  • 3.7 Market value category other vehicles (sedans, vans, 4WD, tractors, utes, mini buses etc.)

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  • 4. Travel - Domestic and International

  • Description of Cover:

    • Cover under the Policy applies whilst on authorised business or activities of Rotary including direct travel to and from such business/activities.
    • Incidental Private Travel is included and 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)

     

    Journey Definition

    • Journey means the trip undertaken on the business of Rotary and/or authorized by Rotary, 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.

     

  • 4.1 Did any travel that meet the above criteria (domestic or international) occur in the twelve months commencing 30 June 2025 or do you anticipate any travel during 2026/2027?

  • Please provide details of all trips for the twelve months commencing  1 July 2026 to the 30 June 2027:

    This includes trips by your members that hold district positions - e.g. The District Governors trips to be included in their clubs' travel figures.

    NB: Each person travelling counts as one trip. 

    • 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.
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  • General Information

  • 4.3 Do you undertake flights in a single engine aircraft?
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  • 4.4 Do you undertake flights in a chartered aircraft?*
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  • 4.5 Do you undertake flights in a helicopter?*
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  • 4.6 Do any of the persons to be covered fly as a pilot or crew in any aircraft other than scheduled airlines?*
  • 4.7 Will any of the persons to be covered be undertaking any activities deemed to be hazardous, dangerous or high risk such as, snow skiing, water sports, mountaineering or trekking, aerial activities, motor sports, abseiling or rock climbing etc.*

  • 5. Op Shop Renewal Questionnaire Form

  • 5.1 General

  • 5.1.6 Do you have any employees?*
  • 5.1.9 Do you have Workers compensation in place for Employees? (Note: If there are paid employees, a Workers Compensation policy must be in place. This must be arranged independently of this insurance program.)*

  • 5.2 Compliance and Legislation

  • 5.2.1 Does your retail store/s or thrift shop comply with Consumer Legislation in relation to second hand goods? In particular, Electrical Goods i.e. Testing and Tagging?*

  • 6. Statutory Notices

  • 7. 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
  • Format: 000 0000 000.
  • Date*
     - -

  • If you have any queries or require assistance, please contact your District Insurance Officer (DIO):

     

    District  Contact Name  Contact No.  Email
    9423 Steve Halbert 0439 301 406 dio@rotarywa.au
    9510 John Rix 0408 003 093 johnrix@riverland.net.au
    9560 Col Craig 0458 741 536 insurance@rotary9560.org or
    col.craig@rotary9560.org
    9620 Tony Sykes 0412 311 871 tonys@giba.com.au
    9620 Subhashni Singh 0406 764 113 subhashni_ss@hotmail.com
    9640 John Giuricin 0419 303 050 insurance@rotary9640.org
    john@alltours.com.au
    9660 Brett White 0427 659 606 brett@trubrett.com.au
    9675 Joanne Glaser 0418 227 812 joanne.glaser@uig.net.au
    9685 Dallas Booth 0412 445 454 dallaswbooth@live.com
    9705 Vicky Hale 0438 452 218 insurance@rotary9705.au
    chris@abroearth.com.au
    9780 Don Shields 0419 390 303 don@gibvic.com.au
    9790 David McPherson 0408 629 644 dmcpherson2710@gmail.com
    9800 Vicki Hale 0438 452 218 insurance@rotary9800.org
    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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