Quote Request Form Strata 1 2 3 Please forward us the following details to get insurance quotes: OC Number Address of situation No of Units Year of Built Renewal Dates BUILT STRUCTURE Roof(s) No of storey(s) Walls GF Upper Floors 1 2 3 CLADDING INFORMATION TYPE: EPS ACP Floor Construction(s) Heritage Listed YesNo Pool(s)/Playground(s) No of Lift(s) No of Car Stacker(s) Floating FloorsYesNo Flood Cover (Residential Only)YesNo Are there any known building defects or hazards: Yes/No – if Yes, provide detailsYesNo 1 2 3 INSURANCE LIMITS OF COVER BUILDING SUM INSURED COMMON CONTENTS LOSS OF RENT/TEMP ACCOM PUBLIC LIABILITY VOLUNTARY WORKERS FIDELITY GUARANTEE OFFICE BEARERS MACHINERY BREAKDOWN CATASTROPHE COVER REQUIRED OR NOT PREVIOUS INSURERS (5 YEARS) IF DIFFERENT CLAIMS HISTORY (5 YEARS) Policy Period Lot no/Common Area Description Claims Amount 2015-2016 2016-2017 2017-2018 2018-2019 2019-2020