Fenton Green & Co.

CPA Members Business & Office Insurance Quote Request

Name of Firm		Contact Name
Contact Phone		Email

Are you currently insured? Yes No
Current Insurer	Current Expiry Date
We request that you attach a copy of your current insurance schedule. We request this document in order for us to provide you with equivalent if not better coverage and policy conditions.


Situation of Risk

CONSTRUCTION, SECURITY & FIRE PROTECTION

Building Construction		Security & Fire Protection
Modern Office Complex with Risk above 2nd floor		Fire Extinguishers
Brick Walls / Concrete Floor		Fire Sprinklers
Combustible (Timber)		Office building with 24 hour security
Approx. Age of Building		Deadlocks / Swipe card NO Alarm
		Deadlocks / Swipe card WITH Alarm
		Monitored back to Base
		Local Alarm

COVER REQUIRED

FIRE

Cover Required Yes No

BUSINESS INTERRUPTION

Cover Required Yes No

BURGLARY

Cover Required Yes No

MONEY

Cover Required Yes No

ALL GLASS REPLACEMENT

Cover Required Yes No

LIABILITY

Cover Required Yes No

GENERAL PROPERTY

Cover Required Yes No

(ANYWHERE IN AUSTRALIA COVER)

Covers laptops, mobile Phones, GPS Units Etc..,

BREAKDOWN OF ELECTRONIC EQUIPMENT

Cover Required Yes No


Do you have Professional Indemnity with Fenton Green	Yes No
If NO, would you like us to contact you to discuss prior to the expiry of your cover?	Yes No Expiry Date

Would you like information on Tax Audit Cover?	Yes No