Hospitality Request a Quote

Request a Quote

Hospitality

Main Contact – Name(s)

Phone Number

Postal Address

City

State

Post Code

Entity Name

ABN

Directors – Name(s)

Business Description (What do you do?)

Benchtop Deepfrying Unit

Yes
No

Standalone Deepfrying Unit

Yes
No

Is the Rangehood or Extraction Fan cleaned BI-Annually?

Is the Rangehood or Extraction Fan cleaned BI-Annually?
YesNo

Is there a Cool Room?
YesNo

Is the a wok?
YesNo

Dangerous Goods on Site
YesNo

Building Age

External Wall Construction

Floor Construction

Roof Construction

Fire Security
Fire ExtinguishersHose ReelFire Blanket24/7 Fire Station NearbyRural Fire Access OnlyTown WaterLocal Fire AlarmsMonitored Alarms - by a Third PartySprinkler System

Security
DeadlocksWindow Bars/ScreensLocal AlarmMonitored AlarmSecurity Fence

Highly Combustible Material (e.g. EPS or ACP)

YesNoUnsure

Asbestos Present?

YesNoUnsure

PROPERTY DAMAGE

Building Sum Insured: $

Contents Sum Insured: $

Stock Sum Insured: $

BUSINESS INTERRUPTION

Gross Turnover (excluding GST): $

Total Purchases: $

Total Wages: $

PLATE GLASS

Is Plate Glass Required?
YesNo

Internal or External Glass?
BothInternalExternal

Is Sign Cover Required?
YesNo

MONEY

Money at Premise: $

Money Away from Premise: $

Money at Premise Overnight: $

Money in Safe: $

Money in Transit: $

Money at Private Residence: $

MACHINERY BREAKDOWN

Air-Conditioners: $

Fridges/Freezers: $

Cool Room: $

Other Machinery: $

Loss of Stock: $

PUBLIC & PRODUCTS LIABILITY

Public Liability
$5,000,000$10,000,000$20,000,000

Products Liability
$5,000,000$10,000,000$20,000,000

TAX AUDIT

Do you require Tax Audit cover?
YesNo

DUTY OF DISCLOSURE QUESTIONS

Previous Claims Declined?

Ever been liable for any civil offence or pecuniary penalty?

Ever been charged or convicted of a criminal offence?

Ever had an insurance policy cancelled, declined or terms imposed?

Aware of circumstances which could give rise to a claim?

Anything to Declare under Duty of Disclosure?

Jakoop Brokers Pty Ltd T/As Simplify My Insurance
CAR No. 1315829 l ABN 22 637 887 506

Authorised Representative of Community Broker Network Pty Ltd
ABN 60 096 916 184 | AFSL 233750

Business Info

Address:

Phone:

Email:

123 Parkyn Parade, Mooloolaba QLD 4557

(07) 3123 6100

hello@simplifymyinsurance.com.au