Online Annual Construction and Liability Insurance Renewal Declaration Form

Please completed to submit this form prior to your insurance policy expiry date, to ensure continuity of cover.

This form is required to assist us in assessing your required cover, reconciling the previous estimated turnover, and to provide you with the renewal for the coming 12 months.

All information you provide must be correct, true, and accurate as incorrect or misleading information may alter our quote and jeopardise cover if you proceed with a policy.

Please refer to the CGIB Financial Services Guide, Privacy Statement, General Advice Warning and Duty of Disclosure before completing this form.

You have errors in your submission, they are highlighted in red below

INSURED'S Details

Business Address



Building Activities

Please provide a breakdown of each activity type* %
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  1. Blasting or explosives
  2. Actual excavation work or work in an existing excavation deeper than 10 metres
  3. Underground works such as tunnels, shafts, mines or galleries
  4. Road works or bridges
  5. Work north of the 25th Parallel
  6. Pipelines greater than 250 metres in length
  7. Excavation of Underground services on site (other than to install new services)
  8. Directional (horizontal) drilling or boring greater than 1 metre in diameter (other than piling / piers)
  9. Work in or around an airport or aircraft landing area or working railways or tramlines
  10. Work in oil, gas, chemical or petrochemical plants, including any work on gasline service stations
  11. Work in mining processing plants
  12. Technology which is of prototype nature
  13. Work on landfills, land which is listed on the contaminated land register or application of waste or chemical products to land
  14. Design and construct where you will provide the design
  15. National Heritage or Historic Listed
  16. Swimming pools where such works are greater than 30% of the contract value
  17. Any works in, under or over water
  18. Any works involved in the power industry
  19. Any demolition exceeding 15 metres in height or exceeding 25% of your annual turnover



Please provide a breakdown of the locations* %
NSW % VIC % QLD %  
SA % WA % TAS %
ACT % NT %    
%  

Insurance Details

Please provide an estimate

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$
$
$
$
$
$
$
$
$

Projects Commenced Details

 

Please list all the projects commenced and completed during the Policy Period.

Important Note: Projects that are not listed / declared are NOT covered.

Project 1

X

Add another project
This form records up to 60 projects.

PREVIOUS INSURANCE

Yes    No 
Yes    No 
Yes    No 
Yes    No 
Yes    No 

CONTACT Details

Yes    No

Important Information

By proceeding you agree to the Terms of Use of this site and that you have read and understood this Important Information about answering questions that we ask of you.
We will handle your personal information in accordance with our Privacy Policy.

Completion of this form does not put an insurance policy/cover in place - you will need to contact us to arrange insurance cover.

Other Insurance Needs



Office Insurance
Management Liability
Landlords Commercial
Landlords Residential
Public Liability
Cyber
Motor Vehicle
Home & Contents
Machinery
Travel

* Mandatory Fields

Thank you for completing our online form.
We will endevour to contact you with your insurance details soon.

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