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Sunshine Coast 1800 072 114 | Central Queensland 1800 961 007 | North Queensland 1800 629 701

Steel Pacific Insurance Brokers

The Steel family established Pacific Insurance Brokers in 1982, opening offices in both the Solomon Islands and Vanuatu.

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Business Combined Property Owners

Business Combined Property Owners

Client Code*
Name of Person completing questionnaire:*
Insured Name:*
1) List of Current Tenants & their Occupations*
2) Have there been any material changes to fire and theft protection alarms, devices and the like during the past 12 months?*
- Yes
- No
If YES, please advise full details
3) Is there any history of flood damage at the insured location(s)?*
- Yes
- No
If YES, please advise full details
4) Attached to your email is a summary of your existing cover for review. Please advise the changes required.*
Machinery Breakdown
1) The level of cover and sums insured must be reviewed to ensure they are adequate and continue to meet your requirements. Please advise any changes that are required.*
2) Have you installed new machinery / equipment in the last policy period?*
- Yes
- No
If YES, please advise full details
Property Owner's Liability
1) Estimated Rental Income for the forthcoming year ($)*
2) Number of principals*
3) Number of Staff*
4) Estimated Payroll ($)*
5) Are Contractors/Sub-contractors used?*
- Yes
- No
Activities performed*
Estimated Annual Payments made: $*
Do you sight current Public Liability insurance prior to work commencing?*
- Yes
- No
6) Are Labour Hire personnel used?*
- Yes
- No
Activities performed*
Estimated Annual Payments made: $*
Do you sight current Public Liability insurance prior to work commencing?*
- Yes
- No
Rental Income / Loss of Earnings
The policy is designed to protect loss of rent in the event of damage to the premises. The following formula will be of help in calculating appropriate values for the forthcoming year. Gross Rental Income for the next 12 months (including special outgoings) $
Do you require quotes for:
Rent Default *
- Yes
- No
Eviction Costs*
- Yes
- No
Other Insurances
Are there any other insurance needs e.g. Insurance of Income, Home, Contents, Motor Vehicle, Caravan, Boat etc, with which we can assist?*
- Yes
- No
Claims Declaration
1) Details of any claims that have occurred, but have not yet been reported.*
2) After specific inquiry, details of any facts, circumstances or incidents (other than those already disclosed, notified to your insurer) which could give rise to a future claim.*
All changes or inclusions of any sort or type, including limits or sums insured shown, will take effect from the policy's expiry date unless you request otherwise.

Information we have provided to Steel Pacific Insurance Brokers, is to the best of our knowledge correct.
Office Message Recipient
Select the office you want to which you wish to send your message*
- Maroochydore
- Townsville
- Proserpine
- Mackay
- Ingham
Comments
This field is for validation purposes and should be left unchanged.

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Steel Pacific Insurance Brokers

Experience the Difference

Sunshine Coast
1800 072 114

Central Queensland
1800 961 007

North Queensland
1800 629 701

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Ballyglisheen Pty Ltd trading as Steel Pacific Insurance Brokers
ABN 47 075 780 353
AFSL 230634

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