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Online Premium Indication Request Form

  • DD slash MM slash YYYY
  • Actual Gross Fee Income for the LAST completed financial year or if you are a new business, please provide the estimate for the FIRST year of operation.
  • For Sub-Consultants that maintain a Professional Indemnity policy. If 'nil', enter '0'.
  • In respect of design, work where there is no likelihood of future construction. If 'nil', enter '0'.
  • If 'nil', enter '0'.
    If you answered 'yes' to current insurance arrangements, it is important you provide the following information.
  • DD slash MM slash YYYY
  • DD slash MM slash YYYY
  • Please specify the limits of indemnity required for indication purposes: