LinkedInThis field is for validation purposes and should be left unchanged.Client DetailsClient Name / Legal Entity Name(Required)Client Address(Required) Street Address City State Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Website (Optional)Phone(Required)ACN (Optional)ABN (Optional)Property DetailsBuilding Category(Required) Commercial Free-Standing Residential Strata Residential Free-Standing Building Type - Commercial Free-Standing(Required) Office/Commercial Multi-Story greater than 7 Levels (Inc. Basement) Office/Commercial Multi-Story up to and Inc 7 Levels (Inc. Basement) Retail up to and including 2 levels. Shopping Centre Warehouse - Low Bay Warehouse - High Bay Factory - Single Storey Small Span Factory – Large Span Clubs Tavern/Pub Motels Hotels Church Authorities - Magistrates Court Authorities - Fire Station Authorities - Police Station Civic - City Hall and Town Halls Civic Centre Library Art Gallery Education - Single Storey Education - Multi Storey Multi-Purpose Health Centre Child Care Centre General Hospital Nursing Home Building Type - Residential Strata(Required) Multi-story Apartments up to and including 4 Levels (Inc. Basement) Multi-story Apartments greater than 4 Levels (Inc. Basement) Attached Dwelling - Up to and including 4 Villas. Attached Dwelling - Up to and including 4 Duplexes. Attached Dwelling - Up to and including 4 Town Houses Attached Dwelling - Greater than 4 Villas. Attached Dwelling - Greater than 4 Duplexes. Attached Dwelling - Greater than 4 Town Houses Building Type - Residential FreeStanding(Required) House - Single Unit Attached Dwelling - Villa Attached Dwelling - Duplex Attached Dwelling - Town House Building NameStrata Plan NumberBuilding Address(Required) Street Address City State Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Previous Sum Insured AmountPrevious Sum Insured Date DD slash MM slash YYYY Instructed byInstructing company / entityConstruction DetailsYear Built(Required)Year of Last Renovation over $100k(Required)Number of levels(Required)Number of lots(Required)Number of lifts in the building(Required)Total Building Area (m²)(Required)Is the building heritage listed?(Required) Yes No Is the building habitable?(Required) Yes No Are there any known defects?(Required) Yes No Building materials - External walls - Select All that Apply(Required) Artificial Weatherboard Blockwork Brick Veneer Concrete Double Brick Glass Metal Panel Wall System Rendered Masonry Sheer Cladding Stonework Stonework Veneer Timber Weatherboard Other Please specifyBuilding materials - Roof(Required) Concrete Concrete Tile Metal Slate Terracotta Tile Other Please specifyBuilding materials - Floors(Required) Concrete Timber Other Please specifyBuilding materials - Internal Walls and Ceilings(Required) Brick Veneer Concrete Plasterboard Rendered Brick Timber Other Please specify)Building materials - Asbestos(Required) Yes No Most Likely Unsure External Improvements - Please select the type of external improvements done on the property(Required) Pool Carport (sqm) Detached Garage (sqm) Spa Landscaping incl. Hardpaved Driveways (Small Area <100sqm) Landscaping incl. Hardpaved Driveways (Large Area >100sqm) Carparking - Underground (per car space) Carparking - Aboveground (per car space) Outdoor Entertainment Area Tennis Court Boat Jetty/Wharf (per berth) Playground Detached Shed (sqm) None Please enter Carport (sqm)Please enter Detached Garage (sqm)Please enter number of Underground car spacesPlease enter number of Aboveground car spacesPlease enter number of berthsPlease enter Detached Shed (sqm)Site imagesPlease supply images of the improvements if available Drop files here or Select files Max. file size: 72 MB. Site DetailsType of Slope(Required) Flat/Gentle (up to 10 degrees) Moderate (10 – 20 degrees) Severe (>20 degrees) Building Standard (Quality of Construction)(Required) Standard Quality Prestige Access around site(Required) Unrestricted Restricted Additional Information
