Corporate Travel (SCHEME) Corporate Travel Instant IndicationThis is an exclusive scheme for the following Brokers only: Apollo Risk Services Nexus Risk Services Oracle Group Insurance Brokers Willis Temby Insurance Brokers If you are not from one of the above, please use our standard product. If you would like to see your company listed above, please contact us. If you are from one of the above, please continue below and enjoy the exclusive benefits. Tier *1. International upto 15 | Domestic upto 302. International upto 20 | Domestic upto 403. International upto 25 | Domestic upto 504. International upto 30 | Domestic upto 60Be sure to include all business &/or pure leisure trips TIER 1 WA, VIC, TAS & NT (10%) NSW & QLD (9%) SA (11%) ACT (0%) Base Premium $850.00 $850.00 $850.00 $850.00 GST $17.50 $17.50 $17.50 $17.50 Stamp Duty $26.00 $17.55 $28.60 $0.00 UW Agency Fee $25.00 $25.00 $25.00 $25.00 GST on Fee $2.50 $2.50 $2.50 $2.50 Total $921.00 $918.40 $923.60 $895.00 TIER 2 WA, VIC, TAS & NT (10%) NSW & QLD (9%) SA (11%) ACT (0%) Base Premium $1,100.00 $1,100.00 $1,100.00 $1,100.00 GST $20.00 $20.00 $20.00 $20.00 Stamp Duty $31.00 $27.90 $34.10 $0.00 UW Agency Fee $25.00 $25.00 $25.00 $25.00 GST on Fee $2.50 $2.50 $2.50 $2.50 Total $1,178.50 $1,1175.40 $1,072.10 $1,147.50 TIER 3 WA, VIC, TAS & NT (10%) NSW & QLD (9%) SA (11%) ACT (0%) Base Premium $1,375.00 $1,375.00 $1,375.00 $1,375.00 GST $25.00 $25.00 $25.00 $25.00 Stamp Duty $38.75 $34.88 $42.63 $0.00 UW Agency Fee $25.00 $25.00 $25.00 $25.00 GST on Fee $2.50 $2.50 $2.50 $2.50 Total $1,466.25 $1,462.38 $1,470.13 $1,427.50 TIER 4 WA, VIC, TAS & NT (10%) NSW & QLD (9%) SA (11%) ACT (0%) Base Premium $1,650.00 $1,650.00 $1,650.00 $1,650.00 GST $30.00 $30.00 $30.00 $30.00 Stamp Duty $46.50 $41.85 $51.15 $0.00 UW Agency Fee $25.00 $25.00 $25.00 $25.00 GST on Fee $2.50 $2.50 $2.50 $2.50 Total $1,754.00 $1,749.35 $1,758.65 $1,707.50 This indication is based on the following assumptions: Travel is White Collar &/or Blue Collar other than for; FIFO, Sporting organisations; professional sports persons or those engaged in industries such as: FIFO; Work off-shore or underground; Defence Force; Commercial Divers; Seaman; Commercial Fishermen; Emergency Services; Piloting or Aircrew; Oil Riggers; Correction Officers; Taxi Drivers; The Insured’s total cost of claims over the past 2 years is below $2,000; The Insured is domiciled in Australia and has an ABN; There are no charter flights in the trip estimates scheduled to be undertaken; There are no trips to: Afghanistan, Central African Republic, Chad, Cuba, Iraq, Iran, Libya, Mali, Niger, North Korea, Papua New Guinea, Pakistan, Somalia, Sudan, South Sudan, Syria, or Yemen; There are no more than 5 trips (whether International or Domestic) to be undertaken that are longer than 25 days duration Should you wish to receive formal terms and/or for us to bind, please use the “next” button below to complete sections 2 – 6.Insured's DetailsName Of Insured *Only 1 entity per policy allowedABN *0 / 11Occupation *Is the Insured or any Insured Persons, FIFO, a sporting organisation, professional sports person or engaged in industries such as: Government; Defence; Diving; Seaman; Piloting; or Aircrew?(No cover applies to such activities unless disclosed to us and agreed by us in writing)NoYesStreet Address *Suburb *State *Post Code *Trip DetailsEstimated number of INTERNATIONAL trips *Estimated number of trip within AUSTRALIA *Would you like to insure any charter flights?NoYesNumber of FIXED WING charter flights whilst OVERSEAS *Number of HELICOPTER charter flights whilst OVERSEAS *Number of FIXED WING charter flights within AUSTRALIA *Number of HELICOPTER charter flights within AUSTRALIA *Afghanistan, Central African Republic, Chad, Cuba, Iraq, Iran, Libya, Mali, Niger, North Korea, Papua New Guinea, Pakistan, Somalia, Sudan, South Sudan, Syria, or Yemen? (Please note that any trips to these countries will only be covered if declared to us and agreed by us in writing and trips to Cuba, Iran or North Korea cannot be covered under any circumstances)NoYesWill there be any trips that exceed 180 days?(Please note that such trips are not covered unless declared to us and agreed by us in writing)NoYesPlease split the trips into the following categories (by %)Business - White Collar (%) *Business - Blue Collar (%) *Holiday / Leisure Travel (%) *Cover DetailsHolding Underwriter *Expiry date *Proposed Inception date *for a period of 12 months to and from 4:00pm Local Standard Time at the address of the proposed Insured unless stated otherwiseClaims HistoryIn the last 3 years has the proposed Insured made any travel Claims?NoYesLast 12 Months:Paid *Outstanding *IncurredPrevious Year:Paid *Outstanding *IncurredPrevious Year:Paid *Outstanding *IncurredInstructions & Broker DeclarationInstructionsQuote or Quote & Bind *Please provide formal Quote onlyAssuming premium is as per the indication, please quote, bind and confirm you are on risk I hereby Declare that:I have explained the Duty of Disclosure to my clientThe information provided is a true, accurate and complete reflection of the answers provided to me by my clientBrokers Name *Broking House *Brokers Email Address *Brokers Phone Number *Are you an AR? *NoYesIf Yes, who are you an AR of? *Important InformationA full copy of your answers will be automatically emailed to you upon hitting the submit button below. You are welcome to forward this to your client for their signature for your records if required (we do not require this).Submit to Edge