Construction Insurance
(Contractors Plant and Equipment)
Application form filled in by
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Please Select
Applicant
Insurance Web Representative
Other
Office staff member:
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Please Select
Suzy Pratt
Sonya Wilmen
Jason Matthey
Travis Rock
Other
How did you hear about us?
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Searching online for insurance providers
Web Advertisement
Word of mouth referral
Yellow Pages online
Email marketing
Via "Fiducial Group"
Via "Total Advice Partners"
Other
Information about completing this form on-line
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By completing and submitting this application form you are consenting to have quotations for this class of insurance obtained from various insurance companies that provide this product and who have distribution agreements with United Insurance Group Pty Ltd and Insurance Web Pty Ltd.
Quotations are provided to you obligation free. A completed form does
NOT BIND
the applicant to complete the insurance but does form part of any insurance contract that should develop from the information provided in this document. Persons completing this application must have the right authority to do so or must have the application reviewed and signed off by those persons with the authority to enter into contractual agreements for and on behalf of the entity named in this application.
This quotation facility enables you to lodge a quote request direct to the Insurance Web Customer Service Team with the right information for quick and accurate assessment and thereby provides a superior service in dealing with insurance companies and you as our valued customer.
Simply complete the on-line form and the information will be sent to the appropriate Customer Service team. Following receipt of your request, an email response will be forwarded to you within 2-4 business days.
We are committed to protecting your privacy and confidentiality in accordance with the Privacy Act 1988 (Cth)
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Important - please read before completing this form
Privacy
We are committed to protecting your privacy and confidentiality in accordance with the Privacy Act 1988 (Cth) and it is one our prime concerns that any personal or sensitive information you provide to us is not used for any other purpose than that intended and expected by you. This Privacy Policy overview below, describes our current policies and practices in relation to the handling and use of personal information. You may also see our Privacy policy in our Financial Services Guide (FSG).
What information do we collect and how do we use it?
We will collect personal information for primary purposes, which are relevant to providing and administrating our products and services.
We collect the information needed to enable us to provide advice on and arrange financial services. We will usually provide some or all of this information to our product suppliers. Some of these suppliers may be located outside Australia.
To enable us to assess any claims made under an insurance policy we and our representatives (including loss adjusters, investigators, medical advisors and lawyers) collect information about the claim, some of which may be personal information. We may collect the information from you or from third parties. We provide this information to the insurer and those appointed to assist you in making a claim. We may use personal information internally to help us improve our services and help resolve any problems.
What if you don"t provide some information to us?
We can only apply for and arrange financial service products if we have all relevant information. The insurance laws also require you to provide us with all the information we need in order to be able to decide whether to insure and on what terms.
How do we hold and protect your information?
We hold the information we collect from you in our computer system and in our hard copy files. We ensure that your information is safe by following the usual security procedures expected by our clients.
Will we disclose the information we collect to anyone?
We may disclose information to:
• Insurers, underwriters, underwriting agencies, wholesale brokers and reinsurers
(for the purpose of seeking recovery from them or to assist them to assess insurance risks);
• Premium Funding companies for the purposes of gaining quotations on and arranging funding of your
insurance premiums.
• An investigator, assessor, State or Federal Health Authorities, lawyers, accountants, medical
practitioners, hospitals or other professional advisors (for the purposes of investigating or
assessing your claim);
•
A lawyer or recovery agent (for the purpose of defending an action by a third party against
you or for the purpose of recovery costs including your excess);
• Contractors who supply services to us, e.g. to handle mailings on our behalf.
• An immediate family member;
• Other companies in the event of a corporate sale, merger, reorganisation, dissolution or similar event
However, we will do our best to ensure that they protect the information in the same way that we do. We may provide this information to others if we are required to do so by law or under some unusual other circumstances which the Privacy Act permits. We do not sell, trade, or rent personal information to others.
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Duty of Disclosure
Before you enter into this contract of insurance with an insurer, the Insurance Contracts Act 1984 requires you to tell us and the insurer everything of which you are aware, which you know, or which a reasonable person in the circumstances could be expected to know is relevant to our decision, whether and on what terms your application for insurance is acceptable and to calculate the premium required for your policy.
The Act imposes a different duty the first time you enter into the policy with us, from the duty that applies when you renew, vary, extend, reinstate or replace your policy. We set these duties out below.
Your duty of disclosure applies when you enter into this policy with us for the first time.
You will be asked various questions when you first apply for this policy. When you answer these questions, you must:
• give us honest and complete answers;
• tell us everything you know;
• tell us everything that a reasonable person in the circumstances could be expected to tell us.
Who needs to tell us
It is important that you understand, that you are disclosing to us and answering our questions for both you and anyone else who you want to be covered by the policy.
Non-disclosure or Misrepresentation
If you do not tell us
If you do not answer our questions honestly or do not properly disclose to us, the insurer may reduce or refuse to pay a claim or may cancel the policy. If you act fraudulently in answering our questions or not disclosing to us, the insurer in turn, may refuse to pay a claim or treat the policy as never having existed. This would mean that you were never insured.
Your duty of Disclosure applies when you renew, vary, extend, reinstate or replace your policy
When you renew, vary, extend or reinstate your policy, your duty is to tell us before the renewal, variation, extension or reinstatement, every matter known to you, which:
• you know; or
• a reasonable person in the circumstances could be expected to know;
• is relevant to an insurance providers decision whether to insure you and, if so, on what terms.
What you do not need to tell us when you renew, vary, extend or reinstate your policy
You do not need to tell us about any matter:
• that diminishes the insurance providers risk;
• that is of common knowledge;
• that we know or should know as an insurer; or
* that we tell you we do not need to know.
Non-disclosure and Misrepresentation
If you make a misrepresentation to us, or if you do not comply with your duty of disclosure and we issue your policy with terms and conditions that are different to the terms and conditions that would have been issued had there not been any misrepresentation, or your duty of disclosure had been complied with, then:
• the insurer may reduce the cover provided, so that we are placed in the same position as they
would have been in, had there not been any misrepresentation and your duty of disclosure had
been complied with; and
• the insurer may also cancel your policy; or
• the insurer may treat your policy as if it never existed if the misrepresentation or your
non-compliance with your duty of disclosure was fraudulent.
Policy Details
For full details of cover, please refer to the Product Disclosure Statement and/or Policy wording which sets out the terms and conditions of cover offered. This is available on request and will be sent out with your quotation once prepared.
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Your Contact Information
First Name
*
Last Name
*
Enter your E-mail address
Contact phone number
*
Do you currently have insurance for your Contractors Plant and Equipment?
*
Yes
No
Enter the name of the current insurer
*
Please Select
No previous insurance (New Venture)
No previous insurance (Existing Business operational more than 3 months)
AAMI
ACE
Allianz
AMP
Ansvar
Calliden
CGU
Chartis
Chubb
GIO
Lumley
Miramar
NRMA
QBE
Suncorp
Vero
Zurich
Unknown?
Other
Situation Address of the principal place of operations
Address Line 1
*
Address Line 2
Enter Suburb or City
*
Enter Postcode
*
Select State
*
Please Select
QLD
NSW
VIC
TAS
SA
WA
NT
ACT
Is the mailing address different from the principal place of operations?
*
Yes
No
Please enter your
mailing address
details
Mail Address Line One
*
Mail Address Line Two
Enter Suburb or mail centre location
*
Select Mail State
*
Please Select
QLD
NSW
VIC
TAS
SA
WA
NT
ACT
Enter Mail Postcode
*
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Details of those proposed to be insured
Please select the type of Entity to be insured
*
Please Select
Individual/Sole Trader
Individual/Sole Trader with a Trading name
Australian Private Company (Pty Ltd) with a Trading Name
Australian Private Company (Pty Ltd)
Australian Public Company (Ltd)
Australian Private Company (Ltd) with a Trading Name
Other Entity Type
Enter the Name of the Business
*
Enter your First Name/s
*
Surname
*
Enter the Trading Name
*
Please enter a brief summary/description of your business...
Website address (if you have one)
ABN ( Australian Business Number )
Registered for GST?
Yes
No
Approx date which the Proposer Commenced Business Operations
-
Day
-
Month
Year
Date Picker Icon
Does the business have a Stamp Duty Exemption?
Yes
No
Upload an Attachment
Select File
Cancel
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Duty of Disclosure
Have you or any partner(s) or director(s) of the business:
Made a claim for loss, damage or liability within the past 5 years?
Please Select
No
Yes
if "Yes", please provide a brief description...
Had an insurer decline a claim, cancel a policy or impose special terms within the past 5 years?
Please Select
No
Yes
if "Yes", please provide a brief description...
Been charged or convicted of any criminal convictions?
Please Select
No
Yes
if "Yes", please provide a brief description...
Been declared bankrupt, insolvent, had a liquidator appointed or been a defendant in any civil court case?
Please Select
No
Yes
if "Yes", please provide a brief description...
Been prosecuted or received notice of intended prosecution under any Health and Safety at Work or Consumer Protection Act.
Please Select
No
Yes
if "Yes", please provide a brief description...
Upload an Attachment
Select File
Cancel
of
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Details of Coverage
Cover
Policy Start Date
*
-
Day
-
Month
Year
Date Picker Icon
Policy End Date
-
Day
-
Month
Year
Date Picker Icon
Liability Basis
Please Select
Turnover Basis
Per Item Basis
Not Covered
Please enter last years Turnover ($)
Please select the cover types required...
*
Material Damage
Road Risk Liability
Public Liability
Please select your Road Risk Liability Limit...
*
Please Select
$5,000,000
$10,000,000
$20,000,000
Please select your Public Liability Limit...
*
Please Select
$5,000,000
$10,000,000
$20,000,000
Please select your business type from the list below...
Please Select
Agriculture, Horticulture
Air Conditioning
Bridge Construction
Cartage Contractor
Civil Contractor
Commercial Builder
Commercial Property Owner
Concrete Pumper
Crane Operator
Dams
Drilling or Boring
Dry Hirer
Earthmover
Electrician
Forestry
Forklift Operator
Gas, Oil & Petrochemical
Glazier
Interior Fitout
Landscaper
Marine Construction, Piers, Breakwaters
Mechanical Engineer
Mining - Above Ground
Mining - Below Ground
Owner Builder
Painter
Piling Contractor
Plumber
Power Generation
Property Developer
Quarrying - above ground
Quarrying - below ground
Rail Contractor (not fixing rails or transoms)
Residential Builder
Residential Property Owner
Road Construction
Subdivision Establishment
Swimming Pool Contractor
Tunnelling
Please enter the suburb and postcode where most insured plant is stored...
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Schedule of Plant Items
Please list the plant and equipment you wish to cover below...
Item 1
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 1 Description
Item 1 Year Model
Item 1 Sum Insured
How is item 1 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 1 Registered?
Yes
No
Item 1 Registration Number
Add another item?
Yes
Item 2
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 2 Description
Item 2 Year Model
Item 2 Sum Insured
How is item 2 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 2 Registered?
Yes
No
Item 2 Registration Number
Add another item?
Yes
Item 3
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 3 Description
Item 3 Year Model
Item 3 Sum Insured
How is item 3 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 3 Registered?
Yes
No
Item 3 Registration Number
Add another item?
Yes
Item 4
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 4 Description
Item 4 Year Model
Item 4 Sum Insured
How is item 4 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 4 Registered?
Yes
No
Item 4 Registration Number
Add another item?
Yes
Item 5
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 5 Description
Item 5 Year Model
Item 5 Sum Insured
How is item 5 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 5 Registered?
Yes
No
Item 5 Registration Number
Add another item?
Yes
Item 6
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 6 Description
Item 6 Year Model
Item 6 Sum Insured
How is item 6 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 6 Registered?
Yes
No
Item 6 Registration Number
Add another item?
Yes
Item 7
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 7 Description
Item 7 Year Model
Item 7 Sum Insured
How is item 7 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 7 Registered?
Yes
No
Item 7 Registration Number
Add another item?
Yes
Item 8
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 8 Description
Item 8 Year Model
Item 8 Sum Insured
How is item 8 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 8 Registered?
Yes
No
Item 8 Registration Number
Add another item?
Yes
Item 9
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 9 Description
Item 9 Year Model
Item 9 Sum Insured
How is item 9 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 9 Registered?
Yes
No
Item 9 Registration Number
Add another item?
Yes
Item 10
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 10 Description
Item 10 Year Model
Item 10 Sum Insured
How is item 10 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 10 Registered?
Yes
No
Item 10 Registration Number
Add another item?
Yes
Item 11
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 11 Description
Item 11 Year Model
Item 11 Sum Insured
How is item 11 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 11 Registered?
Yes
No
Item 11 Registration Number
Add another item?
Yes
Item 12
Please Select
4WD
Asphalt Batching Plant
Asphalt Sprayer
Auger
Back Actor
Back Hoe
Baler
Barge
Bobcat
Boom Lift
Buckets
Bulldozer - Rubber Tyred
Bulldozer - Tracked
Caravan - Commercial Use
Cherry Picker
Chipper
Colder Planer
Compactor - Mobile
Compressor
Concrete - Batching Plant
Concrete - Breaker
Concrete - Mixer (Not Truck)
Concrete - Pump
Concrete - Screed
Concrete - Trowler Motorised
Concrete - Vibrator
Crane
Crane - Crawler
Crane - Derrick
Crane - for pipe laying
Crane - Mobile
Crane - Tower
Crusher
Debarker
Dewatering Pump
Digitrak
Directional Driller
Ditch Witch
Dozer
Dozer - Swamp
Dragline
Drilling Rig
Electric Welding Set
Excavator - Hydraulic Over 8t
Excavator - Hydraulic Under 8t
Excavator - Mini
Excavator - Vacuum Truck Mounted
Feller Buncher
Flying Fox
Fork Lift
Formwork
Generator
GPS System
Grader
Hammer
Harvester - Chaser Bin
Harvester - Less than 4 years old
Harvester - Moon Buggy
Harvester - Older than 4 years
Hay Baler
Header - Front
Header - Less than 4 years old
Header - Older than 4 yeras
Header - Platform
Hi Rail Tipper
Impact Breaker
Jumbo Hard Rock Mine
Lifting Platform
Lights - Traffic Portable
Lighting Tower
Loader - Non Skid Steer
Loader - Knuckle Boom
Log - Chipper
Log - Debarker
Log - Forwarder
Log - Harvester
Log - Loader
Log - Skidder
Log - Splitter
Long Wall Miner
Low Loader
Miscellaneous - unspecified items
Motorbike
Mower
Mulcher
Pavement Machine
Pile Driver
Pipe Bender
Pipe Layer
Planter - Subtle Warrior
Pneumatic Tools
Prime Mover
Profiler
Pump
Quad Bike
Raise Bore Drill
Road - Header
Road - Profiler
Road - Reclaimer
Road - Sweeper
Rock - Breaker
Rock - Crusher
Rock - Saw
Roller
Rotary Driller
Sawmill
Scaffolding
Scissor Lift
Scraper
Screen
Sedan
Service Maintenance Vehicle
Shovel
Skid Steer
Skidder
Skip Bin
Snow - Groomer
Snow - Mobile
Soil - Compactor
Soil - Remediator
Soil - Screener
Soil - Vibrating Compactor
Stacker Reclaimer
Sprayer - Agricultural
Sprayer - Paint
Sprayer - Station Wagon
Telescopic Handler
Thunderbird
Tractor
Trailer
Trailer - Dog
Trailer - Dolly
Trencher
Truck - Concrete Pump
Truck - Concrete
Truck - Dump Over 5t
Truck - Dump Under 5t
Truck - Garbage
Truck - Hiab / Palfinger
Truck - Over 5t
Truck - Skip Bin
Truck - Tipper
Truck - Under 5t
Tunnel Boring Machine (TBM)
Turf Laying Machine
Ute
Utility Vehicle
Van
Water - Blaster
Water - Cart
Winches
Other
Item 12 Description
Item 12 Year Model
Item 12 Sum Insured
How is item 12 used?
Please Select
Operated by Insured
Wet Hired In
Dry Hired Out
Is Item 12 Registered?
Yes
No
Item 12 Registration Number
To add more items, please contact your Insurance Web representative after completing this form, or advise us when we contact you regarding this quotation.
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Next
Underwriting Questions - Are there any...
1. Excavation deeper than 10 metres?
Yes
No
2. Blasting or explosives?
Yes
No
3. Underground works, tunnels, shafts or galleries?
Yes
No
4. Road works or bridges?
Yes
No
5. Irrigation Systems, canals, reservoir, dam or siphon work?
Yes
No
6. Any work in, on, around, over or under water?
Yes
No
7. Demolition above 10 metres in height (other than internal non-structural demolition)?
Yes
No
8. Work in or around an airport/aircraft landing area?
Yes
No
9. Work in or around working railways or tramlines?
Yes
No
10. Directional drilling or boring greater than 50cm in diameter other than piling/piers?
Yes
No
11. Work in oil, gas, chemical/petrochemical plants?
Yes
No
12. A tidal zone or on floating platforms or barges?
Yes
No
13. Any of the Insured Plant of a prototype nature?
Yes
No
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Extensions
Please indicate wether you require cover for the following extensions...
1. Acquisitions
Yes
No
Acquisitions Limit
*
2. Agreed Insured Plant Value
Yes
No
3. Appreciation of Plant Value
Yes
No
4. Damage to Goods Lifted
Yes
No
Damage to Goods Lifted Limit
*
5. Dangerous Goods Carriage
Yes
No
Dangerous Goods Carriage Limit
*
6. Dry Hire
Yes
No
7. Finance Gap
Yes
No
Finance Gap Limit
*
8. Hire Cost or Finance Payment
Yes
No
Hire Cost or Finance Payment Limit
*
9. Hired-In Insured Plant
Yes
No
Hired-In Insured Plant Limit
*
10. Multiple Crane Lift
Yes
No
11. Ongoing Hire Costs
Yes
No
Ongoing Hire Costs Limit
*
12. Underground Risk
Yes
No
13. Unintentional Overload
Yes
No
14. World Wide Travel
Yes
No
15. Business Interruption
Yes
No
16. Breakdown
Yes
No
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Plant and Equipment Value
1. What is the total new replacement value of Contractors Plant and Equipment owned by the business?
2. What is the total market value of Contractors Plant and Equipment owned by the business?
3. What is the maximum any one accident limit for owned plant per (1) or (2) above?
4. What is the maximum value of Contractors Plant and Equipment hired in by the business at any one time?
5. What is t he annual hiring charges incurred by the Business?
6. What is the annual hiring charges received by the Business?
Hire Costs: What is the Maximum weekly rate you would pay to hire in the equivalent of a single item of your Insured Plant?
What is the Maximum Hire Cost Indemnity Period in weeks?
Finance Payment: What is the Maximum monthly finance payment you make for a single item of your Insured Plant?
What is the Maximum Finance Payment Indemnity Period in months?
Annual Revenue
Est. Annual Revenue/Turnover
Indemnity Period (Months)
Claims Preparation Costs
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Other Business Particulars
1. The business has been insured in respect of Contractors Plant and Equipment claim free for the past 3 years?
True
False
2. The Contractors Plant and Equipment to be insured is used solely in connection with the business?
True
False
3. The Contractors Plant and Equipment is used only within Australia?
True
False
4. The Contractors Plant and Equipment is operated, maintained and serviced in accordance with the manufacturers recommendations?
True
False
5. The Contractors Plant and Equipment is returned to a lockfast building or secure compound when not in use?
True
False
6. The Contractors Plant and Equipment is inspected in accordance with any statutory regulations?
True
False
7. The Contractors Plant and Equipment is used by operators licensed in accordance with statutory regulations?
True
False
8. The Contractors Plant and Equipment is not used in hazardous conditions e.g. demolition, mining, dynamiting, underground, on or near water, on brigdges etc
True
False
If you "False" was an answer to any of the above questions, please give further details here...
9. If you have been in business for less than 3 years, please give details of previous experience:
10. Is Insurance required for a Harvester / Header / Other Farm Equipment?
Yes
No
If "Yes", to question 10, please answer A to E below...
a) How often are the machines blown down while active?
b) Are automatic fire suppression systems installed on the machines?
*
Yes
No
c) Has the driver been trained to use this particular Harvester / Header?
*
Yes
No
d) Experience of the driver in using this particular Harvester / Header?
*
e) Are any procedures in place to assist the driver in identifying potential obstructions on the farm which may cause damage to the machine?
*
Yes
No
11. Is cover required during loading transit and unloading?
Yes
No
12. Is cover required whilst plant is let out on hire or loan to a third party?
Yes
No
13. If "Yes" to 12, is indemnity to the first hirer required?
Yes
No
14. Does any of the Contractors Plant and Equipment take in and process materials and/or feedstock?
Yes
No
If you answered "Yes" to question 14 and cover is required, please provide the details of such plant:
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Application Process Completion
Please choose your Excess Amount:
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$250
$500
$1000
$2000
$5000
$10,000
$20,000
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Declaration
I/we in effecting insurance in accordance with the information provided in this application declare and warrant:
A) The statements in this application form are true and correct;
B) I/we have disclosed all matters which to my/our knowledge the insurer should
be aware of;
C) That I/we agree to accept that Insurance Web Pty Ltd will use this information
in order to source insurance quotations from various insurance providers;
D) That I/we agree to accept that on receipt of our quotation for insurance cover
Insurance Web Pty Ltd shall also provide the relevant Product Disclosure
Statement and/or Policy Wording for the insurance cover quoted;
E) That I/we have access to and have read the relevant Financial Services Guide
supplied on the website:
www.insuranceweb.com.au
and also supplied
at time of quoting by email/fax/post.
Proposer"s Signature:
Date:
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Day
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Month
Year
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Proposer"s Title:
*
Below is to be hand completed on the hard copy version of the printed form...
Signature
Signed
X ...............................................................
Print name:
________________________________
Your Title: _____________________________
Dated: ......../......../..........
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