Business Insurance - Australia Wide. SME and Public Liability Cover - Insurance Brokers Sydney Melbourne Brisbane Adelaide Perth Hobart - Market Stall Insurance

Marketstall & Trade Exhibitors

AUSTRALIAN & NEW ZEALAND NATIONWIDE INSURANCE SERVICES
Sydney • Brisbane • Melbourne • Adelaide • Perth • Wellington • Auckland

Market Stall & Trade Exhibitors - Insurance

PROPOSAL FORM

Public and Product Liability Insurance Only

Terms and Conditions

PURPOSE OF YOUR MARKET STALL OR STAND -

Section 1

Market

Trade Exhibitor

Garage Sale

Other

Is your stall/stand located: Inside enclosed premises Outside enclosed premises

Please tell us about your business activities

Please tell us more about your Products & Services

Do you import or export products.

What date would you like Cover to start from? - or What is the Expiry Date of your current insurance?	DD / MM / YYYY

LIMITS OF COVER - AND - PREMIUMS:- $10 MILLION AUTOMATIC COVER -

Section 2

Periods of Cover	15sqm or less	25sqm or less	Public & Product Liability Only

Up to 3 months	$110	$130	Please Select the Cover & Premium Required Premium Rates (Includes Stamp Duty)
Up to 6 months	$175	$190
Annual Cover	$195	$205

Standard Claim Excess: $500.00

For Stock Cover or Larger Areas please contact us

PROPOSER DETAILS -

Section 3

Name :
		Name of person, company or entity seeking insurance
Address :
Suburb :		State : Postcode :
Phone :		Fax :
Email :

Have you or any person associated with this activity ever:-

had a Legal Liability claim made upon you or the other person?

ever made a claim for insurance in respect of the type of cover you require?

been refused insurance?

had an insurance claim of any type refused or reduced?

been charged with a crime of any type?

Depending on your answers to these five questions we may need to contact you for further information

DISCLOSURE AND ACKNOWLEDGEMENT DETAILS -

Section 4


Please examine your Duty of Disclosure

Is there anything else you need to disclose to us?

If Yes, please write here what it is that you think we ought to know

I acknowledge this cover / policy is non-cancellable and non-refundable. I acknowledge I have read and I agree to the terms and conditions stated	Your Answer is Mandatory

CREDIT CARD DETAILS -

Section 5

Your credit card will not be processed until insurance cover is confirmed

Card Type

Please complete the authority below

Cardholder Name

Card Number

Expiry Date

Amount $

Thank you we will do our best to respond in the next few hours - but we may need to contact you for further information

For qualifications concerning the information on this page, please click here.