Liability Online Submission

Actuals (last 12 months)

Estimates (next 12 months)

Turnover split for Stamp Duty Purposes

(only complete the states / territories required)

Please Split the Turnover into the following categories

Imports / Exports

Does the Insured import any products or components from overseas?

Does the Insured export any products?

If the Insureds activities includes online sales, and the goods are sent directly from the factory or warehouse (eg. in China), to an overseas customer, please answer "Yes"

Contractors / Labour Hire Employees

Contractors / Subcontractors
Does the Insured engage ANY contractors or subcontractors?

Labour Hire Companies
Does the Insured engage ANY labour hire personnel from labour hire companies?

Internal Labour / Cross Hire
Is there ANY internal labour hire / cross hire within the company group?

This submission is for:

Is existing cover in place?

Expiring Cover

This Insurance

Primary Limit of Liability:

Please note our maximum Primary Limit of Liability is $20m. As you've selected a higher limit we will split this between a $20m Primary policy and an Excess or Umbrella Liability Policy.

Optional Additional Benefits

WARNING: You've appear to have selected the Contractual Liability extension but not the Principals as additional Insureds/Waiver extension. Normally these go together as when accepting the liability of others under contracts the Insured is normally also required to have the Principal as an additional Insured and waive their rights of subrogation in favour of the Principal? 

Select GLUE Cover
SuperGLUE (sections 1 & 2 combined); GLUE Lite (section 1 of SuperGLUE); GLUE (section 2 of SuperGLUE)

Select GLUE Cover
SuperGLUE (sections 1 & 2 combined); GLUE Lite (section 1 of SuperGLUE); 

GLUE Limit of Liability:

Primary / Underlying
Public Liability Policy:

Primary / Underlying
Motor Vehicle Liability Policy:

Primary / Underlying
Workers Comp Policy:

Would you like to add any additional Primary / Underlying Policies?

Sub-Limits
List any Underlying Sub-limits that you wish us to mirror
This has the effect of doubling the underlying sub-limits.

Fees
Does the Insured charge separate fees for professional services?(if they work an a "cost plus" or "lump sum" basis please answer "No")

Blasting
Are any blasting activities undertaken by or on behalf of the Insured?

Please note that upon submission we may need to obtain some additional information regarding their blasting activities

Critical / Safety Critical parts:
Are any safety/critical parts imported/manufactured/exported for the marine, automotive or aviation industries?

Safety / critical parts are defined as: A part, assembly, installation, or production system with one or more essential characteristics that, if not conforming to the design data or quality requirements, would result in an unsafe condition that could cause loss or serious damage to the end item or major components, loss of control, or serious injury.

Demolition
Is there any demolition conducted by or on behalf of the Insured?

Excavation,
Is any excavation conducted by or on behalf of the Insured?

Underpinning, Shoring Up
Are any of these activities conducted by or on behalf of the Insured?

Piling
Is there any piling activities conducted by or on behalf of the Insured?

Scaffolding Activities
Are these conducted by or on behalf of the Insured?

Cleaning Activities
Are these conducted by or on behalf of the Insured?

Hot Works
Are there any hot works activities undertaken by or on behalf of the Insured?

(ie. Welding | Cutting | Grinding)

Working at heights
Does the Insured work at heights exceeding 2 stories

If working in buildings above the 2nd floor, please answer "Yes"

Drilling, Tunnelling
Are any of these activities undertaken by or on behalf of the Insured?

Fracking
Is there any hydraulic fracturing / hydro-fracking / shale gas extraction activities undertaken by or on behalf of the Insured?

Specialty Locations
Are any of the activities undertaken by or on behalf of the Insured on, at, in, or around ANY of the following?

• Abattoirs
• Agriculture
• Airside
• Battery Energy Storage Systems (BESS)
• Canals
• Chemical / Gas / Oil Refineries
• Chemical Manufacturing Plants / Storage Plants
• Dams (Excluding Tailings)
• Data Centres
• Defence Force / Military Sites
• Demolition Sites (Total Asbestos Liability Exclusion Applies)
• Fertiliser Manufacturing Plants (Total Glyphosate Exclusion Applies)
• Food Processing Plants
• Forestry (Total Bushfire Exclusion Applies)
• Gas / Oil Rigs (On-Shore)
• Grain Silos
• Hydrogen Facilities
• Mines (Including Underground)
• Power Distribution Infrastructure (Underground Power Only – Ie. Not Power Poles)
• Power Utilities
• Quarries
• Railway Or Rail Track Infrastructure
• Saw Mills (Total Bushfire Exclusion To Apply)
• Scientific Laboratories
• Security Industry (Excluding Crowd Control And / Or Shopping Centres)
• Shipyards / Docks / Ports / Watercraft
• Solar Farms
• Structures Containing ACP / EPS
• Tunnels
• Waste & Recycling Facilities
• Water Treatment & Desalination Plants
• Water Utilities
• Wind Farms

Quality Assurance Systems

Please describe the Quality Assurance system the Insured operates under (if any) such as: IS09000 series | HACCP | OHS | ISO14000 series | SQF2000 etc. If none of these, does the Insured have a written quality assurance plan?

QA / Risk Management updates
Has the Insured made any changes to their QA or Risk Management over the past policy period?

Risk Management

An Insured's Risk Management details are probably the most important details of all and greatly assist in our understanding of the overall exposure.  This can have a material impact on the premium and deductibles or could even be the difference between us accepting or declining a risk. 

Please describe below what systems/processes/procedures the Insured has inplace to...

1. Identity,
2. Assess,
3. Control (avoid / reduce), and
4. Monitor & review

....risk, relevant to their Public & Products Liability exposure.

Investigations / Fines / Convictions
Has the insured EVER been subject to a WorkSafe (or equivalent): investigation, had a work improvement order issued, or been fined or convicted of any OH&S breach

Are ALL the following statements true?

1. The Insured has arranged independent testing through an internationally recognised body (such as CSIRO / SAI Global / SAA Approvals) to ensure the products meet the required Australian Standard; and
2. Where required, products are labelled with all applicable product safety warnings; and
3. Where required, the products are provided with clear instructions and in English; and
4. All imported products are easily identifiable via batch and bar code systems; and
5. The Insured has a written quality assurance plan for the imported products; and
6. The Insured maintains full rights of recovery against the overseas manufacturers/suppliers

Are ALL the following statements true?

Written Agreements

1. There are written agreements in place with all contractors / subcontractors; and

Insurance Requirements

2. Under the agreement, all contractors / subcontractors are required to carry their own Public & Products Liability and Workers Compensation Insurances at the same levels as the Insured; and
3. Under the agreement, the liability insurance for all contractors / subcontractors is required to contain a blanket Principal's Indemnity extension or if not, the policy is required to be extended to note the Insured as Principal; and
4. Under the agreement, but only if the contractors / subcontractors operate in a Workers Compensation underwritten state (ie. ACT, WA, NT, TAS),  the contractors / subcontractors Workers Compensation insurance is required to be extended to include Principals Indemnity + Waiver of Subrogation (Act Benefits & Common Law); and

Insurance management

5. The Insured has a written procedure to monitor the contractors / subcontractors insurances; and

Suitability / Qualification management

6. Where individual contractors / subcontractors are engaged and/or where the Insured is directly responsible for supervising the contractors/subcontractors, the Insured has a written process to assess the suitability, health/fitness and qualifications of the contractors/subcontractors.

If additional questions are shown below, please complete the relevant details. If no additional questions are shown, please press "Next" to continue.

SCAFFOLD INDUSTRY ADDENDUM:

1. Please split the turnover into the following activities (by %):

2. Please also advise the % of work performed at the following heights:

3. Please advise the % of work performed at the following locations:

Does the Insured ever sell second hand equipment?

Is there any work involving Public Seating,  Stands, and/or Stages?

Is there a digital inspection system:

1. pre and post use / hire with written and photographic records kept?, and
2. for attendances to make alterations?

If you erect scaffolding systems, are "Scaff tags" always used, AND is there a digital system for retaining Staff Tags?

If you dry hire or sell scaffolding systems or parts, are written  instructions provided covering use, maintenance and safety?

If you are erecting, do you have clear, written contracts with customers/clients setting out who is responsible for inspections and their frequency and/or who is authorised to make any alterations to scaffolding?

Does the Insured have a formal, written training process in place?

If erecting, does the Insured retain Handover Certificates? Do they include the signature of the head contractor, and photos of the scaff tags?

Is there any use of technology, such as IoT sensors or software, or CCTV  to monitor scaffolding integrity or on-site safety?

Is there any use of safety nets?

Do they maintain an electronic incident log (reported incidents by staff, contractors or third parties – injuries, incidents or near misses)?

ASBESTOS / DEMOLITION INDUSTRY ADDENDUM:

Does the Insured hold a valid asbestos removal licence?

1. Please split the turnover into the following activities:

a) Asbestos Removal Only (excluding demolition)

b) Demolition with Asbestos Removal

c) Demolition only (no Asbestos Removal)

d) Blasting

e) Excavation / Earthmoving (excluding working underground)

f) Piling / Shoring Up / Underpinning

g) Working Underground

h) Salvage Sales

i) All Other

Please answer the following specific questions that relate to the Insured's cleaning activities:

Please split the estimated turnover (by %) in the the following activities

• Bathroom Cleaning Including Tile & Grout Cleaning
• Builders Clean (External)
• Builders Clean (Internal)
• Car Washing & Detailing
• Carpet / Upholstery Protection (Residential & Commercial)
• Cinema Cleaning (Outside Business Hours) 
• Crime Scene / Drug / Forensic Cleaning / Toxic Mould
• Curtain & Blind Cleaning
• Factories
  (Outside Business Hours or Office Area only During Hours)
• Lawn Mowing & Garden Maintenance
• Office Cleaning (Outside Business Hours)
• Residential: Bond / End of Lease Cleaning / Move Out Cleaning / Spring Cleaning / Renovation Cleans
• Residential Cleaning
• Residential Swimming Pools
• Retail Shop Cleaning (Outside Business Hours)
• Street Cleaning
• Washing & Ironing Services
  (Excluding Laundromats / Dry Cleaners)
• Window cleaning
  (Ground level commercial or up to 2 story residential)

• Body Corporate (Strata) Cleaning
• Chimney Cleaning (Residential)
• Doctors / Dentist Office Cleaning (Excluding Medical Waste)
• Factory Cleaning (Outside Business Hours)
• High Pressure Washing (External Walls, House Washing, Roof, Driveways & Pathways, Patios, Shade Sails, Fences, Mould Removal)
• Office Cleaning (During Business Hours)
• Rubbish Removal (Excluding Asbestos)
• Schools / Childcare Centres (Outside Business Hours)
• Shopping Centres / Common Mall / Arcades / (Outside Business Hours - same day as closing ie. After shops shut for the night only)
• Sports Leisure facilities / Gymnasiums (Outside Business Hours)
• Steam Cleaning
• Window Cleaning (above ground floor commercial & under 10m, or above second story residential & under 10m)

• Floor Polishing, Stripping or Resealing
• Gutter & Roof Cleaning (Excluding High Pressure)
• Hospitals / Medical Facilities / Old Age Homes (excluding Medical Waste)
• Public Toilet Cleaning (Outside Business Hours)
• Shopping Centres / Common Mall / Arcades / (Outside Business Hours - same day as opening ie. Before shops open for the day only)
• Window Cleaning (above 10m, or using an EWP, or using rope access)

• Clubs (eg. RSL / Leagues Clubs) (During Business Hours or if open 24/7)
• Medical Facilities & Hospital Cleaning (including Medical Waste)
• Public Toilet Cleaning (During Business Hours)
• Schools / Childcare Centres (During Business Hours)
• Shopping Centres / Common Mall / Arcades (During Business Hours)
• Sports Leisure facilities / Gymnasiums (During Business Hours)

Clubs (eg. RSL / Leagues Clubs) (During Business Hours or if open 24/7)

Medical Facilities & Hospital Cleaning (including Medical Waste)

Public Toilet Cleaning (During Business Hours)

Schools / Childcare Centres (During Business Hours)

• Shopping Centres / Common Mall / Arcades (During Business Hours)

Sports Leisure facilities / Gymnasiums (During Business Hours)

The total T/O should = 100%

As you've advised this is a new / start-up business, please move directly to the last section

Have there been any:

• new claims reported to previous insurers, in the last 12 months, that occurred prior to Edge being on risk, or
• movements, in the last 12 months, in existing claims that were with previous insurers?

Previous Claims
Has there been any Liability claims in the last 7 years?

Larger Claims
Has there been ANY Liability claims over $25,000 in the last 7 years?

Repeat Claims
Has there been more than 2 claims resulting from similar circumstances in the last 7 years?

eg. damage to underground services, water damage, trip & fall

Uninsured Losses
In the last 7 years,  has there been ANY uninsured Liability losses?

Known Circumstances
After the appropriate enquiries, are there ANY known circumstances that are likely to lead to a Liability claim?

Legal Disputes (previous)
Has the Insured been involved in a ANY commercial or legal disputes which incurred legal costs in the last 3 years?

Authorised Reps
Are you personally, or is your company an AR of someone else?