Strata Questionnaire
Please fill out the following questionnaire so that we are best able to assist you with your insurance needs.
I. Client Information
Insured Name:
*
Property Name:
*
Situation Address
*
Email
*
Phone
*
How did you hear about NSURE?
*
Policy Period (From):
-
Day
-
Month
Year
Date
(To):
-
Day
-
Month
Year
Date
Current Insurer:
Is this a new development?
*
Yes
No
Developer's Name:
Status:
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II. Policy Coverage
Is cover required for flood?
*
Yes
No
Is cover required for floating floors?
*
Yes
No
Do you want to keep the current sums insured?
*
Yes
No
Do you want to increase the sums insured by 3% as per standard renewal?
*
Yes
No
Do you want to specify/update sums insured on renewal ?
*
Yes
No
Building:
Common Contents:
Loss of Rent:
0%
15%
20%
25%
30%
Fidelity:
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
1,000,000
Office Bearers:
1M
2M
3M
4M
5M
6M
7M
8M
9M
10M
Catastrophe Cover:
0%
15%
20%
25%
30%
Public Liability:
10M
20M
30M
50M
Voluntary Workers:
200,000/2000
other
Machinery Breakdown:
10,000
20,000
50,000
100,000
other
Is business interruption required for interruption following machinery breakdown?
Yes
No
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III. Risk Information (1)
Building 1
Built year of building:
No. Residential Lots:
No. Commercial Lots:
Please list all Commercial Tenants For Building 1:
Wall Construction:
Concrete / Stone
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Brick
Expanded Polystyrene (EPS)
Mixed < 75% Brick/Concrete/Iron on Steel
Mixed > 75% Brick/Concrete/Iron on Steel
Galss
Polyurethane
Concrete Tilt Slab
Masonry
Wood
Metal
Other
Roof Construction:
Concrete
Tiles/Slate
Fibro
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Wood
Glass
Other/Mixed (Full/Partial Combustible)
Other/Mixed (NON-Combustible)
Masonry
Asbestos
Expanded Polystyrene (EPS)
Polystyrene
Other
Floor Construction
Concrete
Brick
Other /Mixed (Partial/Full Combustible)
Other /Mixed (NON-Combustible)
Tile
Iron/Steel
Wood
Other
No. Lifts:
No. Levels (including Basements):
No. of Basement Levels
Is your premises more than 50% vacant?
Yes
No
Are any units used a Air BNB Rentals?
Yes
No
Are more than 50% of units let as holiday rentals?
Yes
No
Is the building external wall frame or roof structure constructed of timber?
Yes
No
Is the building heritage or national trust listed?
Yes
No
Common Facilities (Mark all facilities included):
* Pool / Spa
Gymnasium
Water Features
BBQ Area / Playground
Other
*Please provide further details to pool/spa:
Security (Mark all facilities included):
Ramraid Protection
Bars on Windows
Deadlocks on All Windows
Back to Base Alarm
Local Alarm
CCTV
Lighting
Security Patrols
Motion Detectors
Fire Protection (Mark all facilities included):
Fire Extinguishers
Hose Reels
Fire Blankets
Single Supply Sprinklers
Dual Supply Sprinklers
Hard-wired Smoke Detectors
Back to Base Fire Alam
Are fire sprinkler systems installed throughout the building?
Yes
No
If No, what percentage of the building?
Are fire sprinklers installed over balconies?
Yes
No
Was the building subject to Building Code of Australia - Alternative Solution by a Fire Safety Engineer?
Yes
No
Please provide a photograph of the evacuation floor plan of a typical floor.
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Do you have more than 1 building?
*
Yes
No
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III. Risk Information (2)
Building 2
Built year of building:
No. Residential Lots:
No. Commercial Lots:
Please list all Commercial Tenants For Building 2:
Wall Construction:
Concrete / Stone
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Brick
Expanded Polystyrene (EPS)
Mixed < 75% Brick/Concrete/Iron on Steel
Mixed > 75% Brick/Concrete/Iron on Steel
Galss
Polyurethane
Concrete Tilt Slab
Masonry
Wood
Metal
Other
Roof Construction:
Concrete
Tiles/Slate
Fibro
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Wood
Glass
Other/Mixed (Full/Partial Combustible)
Other/Mixed (NON-Combustible)
Masonry
Asbestos
Expanded Polystyrene (EPS)
Polystyrene
Other
Floor Construction
Concrete
Brick
Other /Mixed (Partial/Full Combustible)
Other /Mixed (NON-Combustible)
Tile
Iron/Steel
Wood
Other
No. Lifts:
No. Levels (including Basements):
No. of Basement levels
Is your premises more than 50% vacant?
Yes
No
Is the building heritage or national trust listed?
Yes
No
Common Facilities (Mark all facilities included):
* Pool / Spa
Gymnasium
Water Features
BBQ Area / Playground
Other
*Please provide further details to pool/spa:
Security (Mark all facilities included):
Ramraid Protection
Bars on Windows
Deadlocks on All Windows
Back to Base Alarm
Local Alarm
CCTV
Lighting
Security Patrols
Motion Detectors
Fire Protection (Mark all facilities included):
Fire Extinguishers
Hose Reels
Fire Blankets
Single Supply Sprinklers
Dual Supply Sprinklers
Hard-wired Smoke Detectors
Back to Base Fire Alam
Are fire sprinkler systems installed throughout the building?
Yes
No
If No, what percentage of the building?
Are fire sprinklers installed over balconies?
Yes
No
Was the building subject to Building Code of Australia - Alternative Solution by a Fire Safety Engineer?
Yes
No
Please provide a photograph of the evacuation floor plan of a typical floor.
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Do you want to add additional building?
*
Yes
No
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III. Risk Information (3)
Building 3
Built year of building:
No. Residential Lots:
No. Commercial Lots:
Please list all Commercial Tenants For Building 3:
Wall Construction:
Concrete / Stone
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Brick
Expanded Polystyrene (EPS)
Mixed < 75% Brick/Concrete/Iron on Steel
Mixed > 75% Brick/Concrete/Iron on Steel
Galss
Polyurethane
Concrete Tilt Slab
Masonry
Wood
Metal
Other
Roof Construction:
Concrete
Tiles/Slate
Fibro
Iron/Steel/Aluminium on Steel
Iron/Steel/Aluminium on Wood
Wood
Glass
Other/Mixed (Full/Partial Combustible)
Other/Mixed (NON-Combustible)
Masonry
Asbestos
Expanded Polystyrene (EPS)
Polystyrene
Other
Floor Construction
Concrete
Brick
Other /Mixed (Partial/Full Combustible)
Other /Mixed (NON-Combustible)
Tile
Iron/Steel
Wood
Other
No. Lifts:
No. Levels (including Basements):
Is your premises more than 50% vacant?
Yes
No
Is the building heritage or national trust listed?
Yes
No
Common Facilities (Mark all facilities included):
* Pool / Spa
Gymnasium
Water Features
BBQ Area / Playground
Other
*Please provide further details to pool/spa:
Security (Mark all facilities included):
Ramraid Protection
Bars on Windows
Deadlocks on All Windows
Back to Base Alarm
Local Alarm
CCTV
Lighting
Security Patrols
Motion Detectors
Fire Protection (Mark all facilities included):
Fire Extinguishers
Hose Reels
Fire Blankets
Single Supply Sprinklers
Dual Supply Sprinklers
Hard-wired Smoke Detectors
Back to Base Fire Alam
Are fire sprinkler systems installed throughout the building?
Yes
No
If No, what percentage of the building?
Was the building subject to Building Code of Australia - Alternative Solution by a Fire Safety Engineer?
Yes
No
Are fire sprinklers installed over balconies?
Yes
No
Please provide a photograph of the evacuation floor plan of a typical floor.
Click to Attach
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IV. Building Details
Do you have any commercial tenants with cooking?
*
Yes
No
No. of commercial tenants with cooking:
Is there at least one fire blanket of approved design in the cooking area?
Yes
No
Is there one fully-charged 3.5 litre wet chemical extinguisher installed and mounted in the cooking area?
Yes
No
Are there any deep fryers or any wok cooking?
Yes
No
If yes, how many Litres in total?
Do all deep fryers have an automatic suppression unit and exhaust extraction system?
Exhaust Only
Automatic Suppression
Both
Attach photo if using automatic suppression in deep frying:
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Are all exhaust duct filters cleaned weekly?
Yes
No
Are all exhaust flues (ducting) cleaned by a professional contractor once every 6 months?
Yes
No
Are all fire extinguishment and control devices maintained in efficient working order with annual maintenance by professional contractors?
Yes
No
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V. Building Cladding
Reference to cladding includes any Aluminium Composite Panels (ACP) and Expanded Polystyrene (EPS).
Is Aluminum Composite Panels (ACP) or Expanded Polystyrene (EPS) used on this building?
*
Yes
No
Cladding Supplementary Information
Is the ACP cladding 100% one of the following types?
Alucobond A2
Alpolic A2
Nu-Core A2
Vitracore G2
Alucore
None of the types indicated
Combustible Cladding Details
If the ACP cladding is not 100% of the above, please complete the following sections
Please provide details of make, type and specifications of the Aluminum Composite Panels (ACP):
If specifications of ACP cladding are not available, what colour is the core material?
Please estimate ACP cladding surface area as a % of total exterior surface area:
Please confirm the number of floors of continuous vertical panels:
Note: Unless there is more than 1 level separatingsections of ACP cladding, consider continuous.
Is ACP cladding installed on balconies?
Yes
No
Is ACP cladding installed at ground level?
Yes
No
Please confirm the type of substrate located behind panels:
Please confirm the type of insulation located behind panels:
Please advise details of any other cladding on the building, its location and the percentage of cladding on the building ( please attach any relevant detailed reports)
Please provide photographs of building elevations where composite panels are installed.
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Please provide all reports and other documents relating to cladding. This may include owners corporation meeting minutes. Please provide the Cladding product name, percentage of cladding on the building and location.
Have any suitably qualified specialists been engaged to assess the cladding e.g., building consultant, engineer or fire safety expert?
Yes
No
If yes, when was this requested and what type of specialist was engaged? Please provide the Date, Name of specialist and type of specialist
If no, please provide the date this action will be completed and any reasons for delays:
Has the assessment been completed by the specialist?
If yes, please provide the date completed, a summary of the assessment and a summary of recommended actions or further assessments required.
Please attach copies of any reports produced by the assessment.
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If no, please provide the date this assessment will be completed and any reasons for delays:
Is the owners corporation (including body corporate, strata company or state/territory equivalent entity) taking legal action against a builder/developer in relation to the cladding?
Yes
No
Is yes, provide details of this and the current status of legal action. Include details such as the scheduled dates for hearings, mediation, site visits for the builder/developer to make further assessments and copies of any deeds of settlements or expected deed execution date.
Has the cladding been signed off as compliant by a suitably qualified fire engineer? If yes, please provide a copy of the compliance certificate or report.
Yes
No
Has remediation/rectification been recommended?
Yes
No
If remediation/rectification is recommended, has the process been completed?
Yes
No
If yes, please provide completion date. If no, please provide the date the process commenced or when it is due to commence and an estimated completion date.
Is the building subject to an order from the Cladding Taskforce or Government Authority within your jurisdiction?
Yes
No
If yes, provide the name of the authority
Details of remediation/rectification actions under order. Please provide what instruction was given by the relevant authority and action that has been undertaken in relation to the order. This will include make safe works, engagement of specialists, assessments and reports
What make-safe works were required and when was this carried out or provide a timeline/date when will this be carried out?
Does a General Meeting need to be held to approve engaging specialists to carry out required inspections once a cladding report has been obtained?
Yes
No
If yes, has approval been obtained?
Yes
No
If a specialist was required, what date did this occur or when is this scheduled to occur?
What is the timeframe for the specialist to complete their assessment and provide their reports?
If no action has been taken since the report was commissioned, provide the reasons and timeline of what transpired and why no action taken. Please include Meeting Minutes.
What funds does the owners corporation have to address the cladding?
If additional funds are required, what financial arrangements (loan or special levy) have been made to ensure approval for works can be made as soon as possible?
If a special levy needs to be raised, has it been approved or when is the meeting (EGM, AGM) scheduled for this approval?
For NSW risks, if an application has been made to Project Remediate, when was this submitted and what is the anticipated timeframe for a response?
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VI. Defects
1. Are there any known Building Defects/Hazards?
*
Yes
No
Defects Supplementary Information
Please provide copy of all reports outlining the timeline and cost estimates of repair.
Have any suitably qualified specialists been engaged to assess the defects e.g., building consultant, engineer or fire safety expert?
Yes
No
If yes, when was this requested, what type of specialist was engaged and what is their name?
If no, please provide the date this action will be completed and any reason for delays:
Has the assessment been completed by a specialist?
Yes
No
If yes, please provide the date completed, a summary of the assessment and the recommended actions/further assessments required.
Please attach copies of any reports produced by the assessment
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If no, please provide the date this assessment will be completed and any reason for delays:
Is the owners corporation (including body corporate, strata company or state/territory equialent entity) taking legal action against a builder/developer in relation to the defect or cladding?
Yes
No
If yes, provide details of this and the current status of the legal action. Include details such as the scheduled dates for hearings, mediation, site visits for the builder/developer to make further assessments and copies of any Deeds of Settlements or expected deed execution date.
Please provide all reports and other documents relating to all known defects. This may include owners corporation meeting minutes. Please provide a description of the defects below.
Has remediation/rectification been recommended?
Yes
No
If remediation/rectification is recommended, has the process been completed?
Yes
No
If yes, please provide the date completed. If no, please provide the date the process commenced or when it is due to commence and an estimated completion date.
Details of remediation/rectification actions under order. Please provide what instruction was given by the relevant authority and action that has been undertaken in relation to the order. This will include make safe works, engagement of specialists, assessments and reports
What make-safe works were required and when was this carried out or provide a timeline/date when will this be carried out?
Does a General Meeting need to be held to approve engaging specialists to carry out required inspections once a defect report has been obtained?
Yes
No
If yes, has approval been obtained?
Yes
No
If a specialist was required, what date did this occur or when is this scheduled to occur?
What is the timeframe for the specialist to complete their assessment and provide their reports?
If no action has been taken since the report was commissioned, provide the reasons and timeline of what transpired and why no action taken. Please include Meeting Minutes.
What funds does the owners corporation have to address the defects?
If additional funds are required, what financial arrangements (loan or special levy) have been made to ensure approval for works can be made as soon as possible?
If a special levy needs to be raised, has it been approved or when is the meeting (EGM, AGM) scheduled for this approval?
For NSW risks, if an application has been made to Project Remediate, when was this submitted and what is the anticipated timeframe for a response?
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VII. Disclosure
1. Are there any unreported Claims or circumstances known by the Owners Corporation and/or Executive Committee Members which could lead to a claim?
*
Yes
No
If YES, please provide details.
1a. Details:
2. Has insurance ever been declined or cancelled?
*
Yes
No
If YES, please provide details.
2a. Details:
3. Has the Owners Corporation carried out an OH&S Report?
*
Yes
No
If YES, please attach a listing including tenants names and business activity.
3a. If YES, are the recommendations completed?
*
Yes
No
If NO, please supply a copy of the report and status of completion.
4. Does the Owners Corporation have any outstanding Fire Orders?
*
Yes
No
If YES, please supply a copy of the order and status of completion.
5. Are there any construction works, defects rectification, renovations, alterations, or repairs planned in the next 12 months which exceed $200,000?
*
Yes*
No
*Estimated Commencement Date:
*Estimated Cost of Works:
6. Please confirm if in the past 5 years if the Owners Corporation have suffered any uninsured losses.
*
Yes
No
If YES , please provide further details.
6a. Details:
7. Are there any other matters you need to disclose to your insurer (refer to your Duty of Disclosure)?
*
Yes
No
If YES, please provide details or attach additional information.
7a. Details:
8. Please confirm there is a scheduled maintenance programme in place in respect of plant and equipment (e.g. Air-conditioning, Lifts and Retail / Commercial tenancy plant and the like).
*
Yes
No
If YES , please provide further details.
8a. Details:
Important Information
If possible, please provide the following documentation:
Copy of Strata Plans
Copy of Strata Management Statement
Most Recent Flow Test Results
Copy of most recent WH&S Report
Copy of most recent Defects Report
Fire Order (if Applicable)
Cladding Reports (if Applicable)
Attach all files here for the Disclosure section:
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VIII. Declaration
I/We hereby declare and warrant that I/We have read this questionnaire and that the answers given above are in every respect true and correct and that I/We have not withheld any material information.
Name:
Position:
Signed:
Date Signed
-
Day
-
Month
Year
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