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Certificate of Currency
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Tradie Protection
Tradie Form
Insured Name
ABN
Email
Phone Number
Director(s) Name(s)
Insured Address
Address Line 1
Address Line 2
City
State
Area Code
The Gross Turnover Last Financial Year in Australia
The Gross Turnover Last Financial Year in USA/Canada
The Gross Turnover Last Financial Year Elsewhere
The Gross Turnover Current Financial Year in Australia
The Gross Turnover Current Financial Year in USA/Canada
The Gross Turnover Last Financial Year Elsewhere
The Gross Turnover Coming Financial Year in Australia
The Gross Turnover Coming Financial Year in USA/Canada
The Gross Turnover Last Financial Year Elsewhere
Confirm which State/Territory You Operate In
NSW
VIC
QLD
SA
WA
TAS
NT
ACT
Do you Operate Overseas?
- Select -
Yes
No
Do You Handle Dangerous Goods?
- Select -
Yes
No
Do You Handle Asbestos?
- Select -
Yes
No
Do You Operate At Any Of The Following Areas?
NONE
Drag Line Excavators
Highvoltage Power Supply Areas
Airport Tarmacs and Aircraft Hangars
Wharves and Ship Handling Facilities
Underground Mines
Railway Tracks and Related Infrastructure
Steelworks
Do you Perform any Welding?
- Select -
Yes
No
Do you work over 10m in height?
- Select -
Yes
No
Do you dig more than 2m in depth?
- Select -
Yes
No
Do you Import or Export?
- Select -
Yes
No
Do you assume liability or contract in additional exposure?
- Select -
Yes
No
Do all subcontractors carry their own Public & Products Liability insurance?
- Select -
Yes
No
Number of Full Time Employees
Number of Part Time or Casual Employees
PUBLIC LIABILITY - Limit of Liability
- Select -
$5,000,000
$10,000,000
$20,000,000
$50,000,000
PRODUCTS LIABILITY - Limit of Liability
- Select -
$5,000,000
$10,000,000
$20,000,000
$50,000,000
TAX AUDIT
- Select -
Include
Exclude
ACCIDENT & SICKNESS
- Select -
Include
Exclude
TOOL & EQUIPMENT - Unspecified Tools Limit (under $3,000 per item)
Would you like to insure a vehicle/s?
Yes
No
VEHICLE/S - include Registration all Accessories and Modifcations
Drivers including Date of Birth
Finance
If adding a vehicle - will this vehicle/s be used for Driver Education, Racing, Courier/Delivery, Hire Car, Taxi, Uber, Courtesy , Removalist
- Select -
Yes
No
If adding a vehicle - has any drivers lost licence or been suspended
- Select -
Yes
No
If adding a vehicle - has any drivers had any traffic convictions
- Select -
Yes
No
Previous Claims Declined?
- Select -
Yes
No
Ever been liable for any civil offence or pecuniary penalty?
- Select -
Yes
No
Ever been charged or convicted of a criminal offence?
- Select -
Yes
No
Ever had an insurance policy cancelled, declined or terms imposed?
- Select -
Yes
No
Aware of circumstances which could give rise to a claim?
- Select -
Yes
No
Anything to Declare under Duty of Disclosure?
- Select -
Yes
No
Additional Information about you or the property
Submit Form
