ACE IRM Insurance Broking Group

Q400

Request a Quote Even if your policies are not due for renewal at this time, simply complete the following, press submit and we will contact you and forward our quotation closer to your due date. All fields are mandatory and are required to succesfully complete the quote. It is advised you read our privacy policy before filling in the form. [Privacy]
Contact Name
Business Name
Email
Phone
Fax
Location
Date of Birth


Current Insurer
Expiry date of current insurance
Number of years insured

Any claims in past 5 years?		yes no
Ever been declined insurance?		yes no
Ever had any convictions?		yes no
Ever been declared bankrupt?		yes no
If yes to any of the above questions, please provide details.

Public Liability Insurance		Sum Insured
Public Liability
Products Liability
Goods in Care, Custody & Control
Annual Turnover
Do you use Sub Contractors?		yes no

General Property Insurance		Sum Insured
Tools of Trade including Foxtel equipment (Australia Wide)
Specified Items (Items over $1000)

Motor Vehicle Insurance		Just supply us with your current Renewal Invoice and we guarantee to beat the premium by 10%

Tax Audit Insurance Insurance
Limit

Personal Accident Illness Insurance		Sum Insured
Capital Benefits
Accident Weekly Benefits
Illness Weekly Benefits



		Please Note: This is for the use of NON BINDING INDICATIVE QUOTATION purposes only and is subject to a satisfactorily completed Proposal Form Prior to Binding