Name of Office |
State |
Your name |
Your position |
Your contact phone number |
Your Email Address |
How many staff members do you currently have (including directors/partners, full-time and part-time)?(Please convert part-time to the Full-Time Equivalent if applicable. eg. 2 part-time employees working 20 hours each week is equivalent to 1 full-time employee working 40 hours per week) |
What is your Estimated Total Annual Income? (from all activities) |
How much of your income is derived from:
Sales:
Residenital Property Management:
Commrcial Property Management:
Valuations (by a qualified valuer):
*Indemnity in respsect of Valuations is not provided by this insurance unless specifically agreed by special endorsement on the policy. |
What is your current Limit of Indemnity? $1 Million
$2 Million
$5 Million
Other |
Limit you would like to be quoted on $1 Million
$2 Million
$5 Million
Other |
Who is your current Insurer? |
Who is your current Insurance Broker? |
What is your current renewal date?(please state in dd/mm/year)
|
What is your current excess/deductible? |
What is your current Gross Premium (including all fees and charges)? |
How many Professional Indemnity claims have you had in the last 5 years? |
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