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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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Combined General & Products Liability Insurance

Combined General & Products Liability Insurance

Client Code*
Name of person completing questionnaire*
Insured Name*
1. Any changes in your business activities / operations?*
- Yes
- No
2. Estimated Turnover for the forthcoming year: $*
3. Number of Principals:*
4. Number of Staff:*
5. Estimated Payroll*
6. 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
7. 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
8. Any demolition activities*
- Yes
- No
9. Does demolition exceed 3.5 metres in height?*
- Yes
- No
State maximum height*
Percentage of turnover*
10. Do you Dry Hire? (Hire out plant without an operator)*
- Yes
- No
11. Do you use, handle or store explosives?*
- Yes
- No
12. Do you handle, treat remove or transport any asbestos?*
- Yes
- No
13. Please provide a description of your business activities to ensure your Public Liability cover is sufficient.*
Claims
14. Details of any claims that have occurred, but have not yet been reported.*
15. 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.*
Office Message Recipient
Select the office you want to which you wish to send your message*
- Maroochydore
- Townsville
- Proserpine
- Mackay
- Ingham
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 is to the best of our knowledge correct.
Name
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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