Liability Renewal Online Submission (Broker Completed)

Actuals (last 12 months)

Estimates (next 12 months)

Turnover split for Stamp Duty Purposes

(only complete the states / territories required)

Imports / Exports

Contractors / Labour Hire Employees

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? 

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

1. Airports | Bridges | Canals | Dams | Railway or Rail Track infrastructure | Shipyards | Tunnels
2. Chemical refineries | Mines or Quarries | Oil refineries | Oil refineries
3. Power generation or distribution infrastructure (including power stations, poles & lines)
4. Off Shore | Underground | Overseas?

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

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.

Please hit "Next" to move to Loss History

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

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)?

1. Please split the turnover into the following activities:

a) Asbestos Removal Only (ie. excluding demolition)

c) Demolition with 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)

After appropriate enquiry, is the Insured aware of any unreported claim or any other occurrence / circumstance which may develop into a claim under the Liability policy?

After appropriate enquiry, where Edge has not been on-risk for all of the past 5 years, has their been any late notifications (ie. in the last 12 months) that relate to the previous insurer(s)?

Please download the application form HERE or if you already have a prop, please upload it below

Please advise below the desired GLUE Limit of Indemnity

Please advise below the desired GLUE Lite Limit of Indemnity

You can obtain an instant indication HERE

Please download the application form HERE or if you already have a prop, please upload it below

Please download the appropriate application form HERE or if you already have a prop, please upload it below