Request new insurance form

Request new insurance form

Complete this form to request new insurance for a whare and/or sundries eg, sheds; contents; waka; and/or public liability.
Before you begin

Gather any documentation you have that provides details of the property, waka etc. as you’ll be required to enter these details into the form.

Once you submit the form it goes to insurance@kohanga.ac.nz. The Insurance team will contact you to confirm your policy details once this has been confirmed with our insurance provider.

NOTE: All premiums for approved insurances are deducted from the funding drawdown.
Save your progress and complete the form later

This form provides you with an option to save your progress and complete the form later.

The “Submit the form” section at the bottom of the form contains the “Save and continue later” button.

You will receive an email with a link to the form so you can return and finish it when you’re ready.

Important: You are strongly encouraged to use this feature and not leave your “in progress” form sitting open in a browser window.

If you or someone else accidently close the browser window your progress will be lost and cannot be recovered. You will have to start again.
Your details
Your name*
Enter first name / last name.
Role*
Contact number*
Email address*

Occupancy details
Let’s capture a few details about your occupancy before we capture the details for the specific insurance type(s) you require.
Select Kōhanga Reo or office requiring insurance*
Select occupancy arrangement*

LeasedTrust ownedOther, please comment
Comment*
Who owns the building?*
Comment*
Please upload your lease agreement or other document.
Upload your document here

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof
Enter full address of the whare to be insured and/or contents are located.
Enter details here*
Address is not required for waka insurance only.
Mokopuna licence numbers*
Enter mokopuna license numbers,
Is the whare insurance through another insurer, eg if the lease is held by another party? If yes, please provide details.
Please make your selection*

YesNo
Insurance provider*
Cover amount $*
Please upload certificate of insurance.
Upload document here*

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof
What do you want to insure?

Make your selection/s. *
Whare and/or sundries eg, shed, garage etc.
Contents
Waka
Public liability
Note: If the building is leased, please refer to your lease agreement for insurance details for the building only. You will need to complete this form to request content insurance.

Whare and sundry
Request whare insurance for buildings owned by the Trust or Kōhanga Reo directly.

Whare and sundry details

Please describe the property overall and identify the number of main buildings and secondary buildings and structures, eg garages, sheds, fencing, decks, shade sails etc. This form allows for four main buildings, and up to 15 secondary building or structures to be identified.
Enter whare details here*
Please describe the property as well as all buildings and structures on the property.
Main buildings

This section collects details for the main buildings on a property.

A main building is the mokopuna learning area, not a garage or shed.

If there is more than one main building, please provide a name for each as you complete these sections so we can correctly identify each one. For example, your first building may be for “Kōhanga Reo under twos” and your second building may be “Kōhanga Reo over twos".

To create an insurance profile for each building, we will be asking for what materials have been used in construction, how large the building is, the age of the building etc. These details are used to calculate the insurance premium.

All questions below are relevant for each building.
How many main buildings on the property?*

1234
Main building one
Main building name*
Please enter building name, eg “Kōhanga Reo under twos” or “Kōhanga Reo over twos".
Square meterage *
Purchase price or whare cost *
Year built
Enter actual year if known.
Decade it was built (approx)*
Please select the decade.
Whare material

We need to know about the materials used for the roof and walls.
Roof*
Comment
Walls*
Comment
Main building two
Main building name*
Please enter building name, eg “Kōhanga Reo under twos” or “Kōhanga Reo over twos".
Square meterage *
Purchase price or whare cost *
Year built
Enter actual year if known.
Decade it was built (approx)*
Please select the decade.
Whare material

We need to know about the materials used for the roof and walls.
Roof*
Comment
Walls*
Comment
Main building three
Main building name*
Please enter building name, eg “Kōhanga Reo under twos” or “Kōhanga Reo over twos".
Square meterage *
Purchase price or whare cost *
Year built
Enter actual year if known.
Decade it was built (approx)*
Please select the decade.
Whare material

We need to know about the materials used for the roof and walls.
Roof*
Comment
Walls*
Comment
Main building four
Main building name*
Please enter building name, eg “Kōhanga Reo under twos” or “Kōhanga Reo over twos".
Square meterage *
Purchase price or whare cost *
Year built
Enter actual year if known.
Decade it was built (approx)*
Please select the decade.
Whare material

We need to know about the materials used for the roof and walls.
Roof*
Comment
Walls*
Comment
Secondary buildings or fixtures

This section collects details for all of the secondary buildings and fixtures on the property. This includes all garages, sheds, decks, fencing, shade sails or other permanent fixtures eg. indoor or inground pool.

Select the type, give it a name to help us identify it, then complete the other details.

If there is more than one secondary building, please provide a name for each as you complete these sections so we can correctly identify each one, eg. shed 1, shed 2, garage 1.

You can add a comment in the last column – keep typing to add your full comment even if you can’t see the whole sentence, as it is all captured.

Documentation

Upload paperwork to confirm purchase and value of main buildings and any secondary buildings and fixtures.
Upload documents here*

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof

Contents
Insurance amount required?*
Contents value is based off your asset schedule.
Note: Minimum contents cover is $20K
Documentation

Please upload your asset schedule to confirm assets.
Upload documents here*

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof

Waka
Complete the table for each waka you want to insure.

Waka details

	Is the waka leased or under finance?	Reg number	Waka make	Waka model	Waka colour	Waka year	Date of purchase	Purchase price	Book value, if known	No. of car seats currently in waka	Where is waka stored	Does waka have accessories? If yes, please comment
1
2
3
4
5

Note: Accessories are extras not supplied or fitted by the manufacturer of your vehicle as standard. These need to be specified for insurance purposes any may include:
- Alloy wheels
- Car seats
- Custom parts or equipment.
Upload your lease / finance agreement/s*

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof
Upload your sales and purchase agreement*

Please upload or drag and drop your files here
Multiple files can be uploaded to a combined total of 10mb. Cancelof
Comment

Public liability insurance
Enter number of kaimahi at your Kōhanga Reo*
Enter the total amount of both paid and volunteer kaimahi.
NOTE: Number of kaimahi includes all paid and volunteer kaimahi.

Submit the form
Thanks for completing this form to request new insurance. Once you submit the form it goes to insurance@kohanga.ac.nz.

You will also receive a copy via email.

The Insurance team will contact you to confirm your policy details once this has been confirmed with our insurance provider.

Note: That all premiums for approved insurances are deducted from the funding drawdown.
Review the form to ensure you have completed all relevant fields and attached all requested documentation, then click Submit.
Using the “Save and continue later” feature:

After you click the Save and continue button, choose to “Skip Create an Account”.

Then, enter your email address and click Send. Within a few minutes you should receive an email with a link to access your form again later.

If you wish, you can also click the Get draft link button, then paste the link somewhere, eg into a Word document or email as a back up.
Should be Empty:

	Type	Name for building or fixture	Size (square metre or length)	Decade built	Actual age (if known)	Roof materials	Walls / fencing or deck materials	Comment
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15