Miscellaneous Professions Insurance Professional Indemnity and Public & Products Liability Step 1 of 8 - Policy Pre Registration - Step 1 0% HiddenBroker Code HiddenBroker Name HiddenBroker Website HiddenBroker Logo HiddenBroker Company HiddenBroker Email HiddenCerberos FSG Use Cerberos FSG HiddenFSG Location HiddenAR Broker Yes No HiddenPolicy Created ByBrokerUserPolicyIDAccess CodeHiddenStatus HiddenToday DD slash MM slash YYYY Thank you for choosing to apply online. Please complete the details below to get started. The process is quick and easy and will only take a few minutes.When do you want this insurance to start?* DD slash MM slash YYYY HiddenDate - Text HiddenPolicy Finish Date DD slash MM slash YYYY Policy Finish Date - HiddenFinish Date plus one year DD slash MM slash YYYY HiddenBinder Doc1 HiddenBinder Doc2 HiddenUMR How did you hear about us?*ReferralWeb SearchAdvertOtherCAPTCHAThis site uses cookies to track your progress through the application process. As part of EU law we must get your permission to store cookies on your computer. View our Cookies Policy (opens in new tab)Consent* I consent to storing cookies General Advice Warning This information may be regarded as general advice. That is, your personal objectives, needs or financial situations were not taken into account when preparing this information. Accordingly, you should consider the appropriateness of any general advice we have given you, having regard to your own objectives, financial situation and needs before acting on it. Where the information relates to a particular financial product, you should obtain and consider the relevant product disclosure statement before making any decision to purchase that financial product. Policy Wording 1 Policy Wording 2 Financial Services Guide Your Policy Start Date - HiddenRetroactive Date Day Month Year Please complete the details below to get an indicative quote:Occupation*_Please select an occupation_Accountant - Accounts PreparationAccountant - BookkeeperAccountant - Business Activity StatementsAdoption AgencyAdvertising AgentAnthropologistArbitrationArbitratorArchaeologistArchival FirmArt DirectorAuthorsBookbinderBotanistBudgeting CoachBusiness Administrative ServiceBusiness CoachBusiness Consultants/Business ManagersBusiness Planning ConsultingBusiness Project Manager (Not Construction)Business Training CourseCareers Advisory ServiceCatering ConsultingChange Management ConsultingCivil CelebrantClerical ServicesCommunication ConsultingCompany Search AgentsCompliance ConsultingCooking InstructorCopywritersCorporate Identity ConsultantsCourt ReporterDance InstructionDance SchoolDesktop PublishingDigital Marketing AgencyDigital Marketing ConsultingEcology AdvisorEconomistEditorial ConsultantsEducation Advisory ServicesElectrical InspectorEmployment AgentEmployment ConsultingEnergy ConsultancyEnergy RatingEntomology ConsultingEssential Safety Measures AuditsExport ConsultantsFood Hygiene ConsultancyFood Industry ConsultantsGemologyGenealogistsGeographerGovernment ConsultingGraphic DesignerGreen AuditorHealth and Safety ConsultancyHistorianHome Sustainability AssessorHospital ConsultingHotel ConsultingHuman Resource ConsultancyHygiene ConsultingIllustratorImage ConsultantsInterpreterJournalistLapidary ConsultingLegal Costing ServiceLibrarianLighting ConsultancyLiterary AgentManagement ConsultantsMap Drawers / CartographersMarket Research ConsultantsMarketing ConsultantsMarriage CelebrantMedia Account ManagersMedia BuyersMedia Development ManagersMediatorsMotel ConsultingMultimedia ConsultingNumismatics ConsultingOccupation Health & Safety ConsultancyOrganisational Structure and StaffingPhilatelic ConsultingPhotographerPhotographic StudioPlant HiringPlant LeasingPool Safety ConsultingPrint BrokingPrint Design and Production ServicesPrint Management ServicesPublic Relations ConsultantsPublicistQuality Assurance ConsultantsRegistered Training Organisation - Classroom BasedRegulatory ConsultingRelocation AgentsResearch ConsultancySecretarial ServicesSecretarial/Word Processing AgenciesSmall Business Advisory ServicesSolar Energy ConsultingSpending PlannerStatisticianStocktakersStrategic PlanningSustainability AssessorSustainability AuditorTeacherTechnical WriterTest and Tag Electrical InspectorTextile ConsultingTextile DesignerTraining - Classroom BasedTraining ConsultantsTraining ConsultingTraining Services (100% Classroom Based)Translators / InterpretersWedding PlannersWorkflow Efficiency ConsultingWorkplace AssessorWriters ConsultingPlease select a occupation from the listAdditional Services I/We provide additional services that need to be specified If occupation is Other OR you have additional activities, enter them here.Additional Services*Business Description*Please summarise your business activitiesProfession referralHiddenProfession Category* Please select your occupation from the above listPlease provide your actual total revenue or turnover for the previous financial year:Last Financial Years Total Revenue*$0 to $250,000$250,001-$500,000Current Financial Years Estimated Total Revenue*$0 to $250,000$250,001-$500,000HiddenOverseas Income (If applicable) Last Financial Year Provide details of the industry and income you derive from OverseasHiddenOverseas Income (If applicable) This Financial Year Provide details of the industry and income you derive from OverseasLast Financial Years Total Revenue Earned OverseasCurrent Financial Years Estimated Total Revenue Earned OverseasFor the purpose of calculating stamp duty please confirm the percentage of revenue earned in each state (must add up to 100%):ACT*NSW*NT*QLD*SA*TAS*VIC*WA*Overseas*HiddenTotal percentage States*HiddenTotal states should equal 100*Total States should equal 100%Are you a small business eligible for exemption from paying NSW stamp duty on certain types* Yes No The NSW Government has created a new small business stamp duty exemption in the Duties Act 1997 (NSW) (the Act) for eligible insurance acquired on or after 1st January 2018 where the proposed Insured is a Capital Gains Tax small business entity (within the meaning of section 152-10 (1AA) of the Income Tax Assessment Act 1997 of the Commonwealth) and a small business individual / partnership / company and/or trust, which is carrying on a business that has an aggregated turnover of less than $2 million. If you are uncertain whether you are classified as a small business we recommend you seek professional advice and speak to your accountant or financial adviser.Due to some of your answers, your quote will be sent for review Your Policy Start Date - Please select the limit of Indemnity required:Professional Indemnity Limit Required*$1,000,000$2,000,000$5,000,000$10,000,000Public & Products Liability Limit Required*$5,000,000$10,000,000$20,000,000Compulsory minimum $5M automatically included in this ratingDo you currently have a valid professional indemnity policy?* Yes No HiddenUnlimited / Inception HiddenIs Renewal? No Yes HiddenProfessional Indemnity Limit AggregateYour Indicative Quote:HiddenExcess Options*$1,000 PI and $500 PLHiddenRetroactive Cover Options*UnlimitedExcess Professional Indemnity $1000, each and every claim, Public & Products Liability $1000, each and every claim. HiddenPI Excess AmountHiddenPL Excess AmountHiddenBase Premium DiscountHiddenBase PremiumHiddenBase Premium DiscountedHiddenPL endorsement message HiddenPI endorsement message Below MinimumAbove MinimumHiddenBase Premium Final*HiddenBase PI*HiddenBase PL*HiddenNSW Stamp Total*HiddenQLD Stamp Total*HiddenVIC Stamp Total*HiddenSA Stamp Total*HiddenWA Stamp Total*HiddenNT Stamp Total*HiddenTAS Stamp Total*HiddenOVS Stamp Total*HiddenTotal Stamp dutyHiddenAdmin Fee*HiddenBroker Fee*HiddenBase Premium GSTHiddenBroker Fee with GSTHiddenAdmin Fee with GSTHiddenTotal GST*HiddenPI AggHiddenPolicy Total AmountWe cannot provide pricing at this time as some of the questions you have answered require a review. Your Policy Start Date - About Your Work Please answer the following questions:Number of staff including principals and employees*Please enter a number from 1 to 100.Are you professionally qualified for the work undertaken and you want to insure?* Yes No You have answered no to being professionally qualified for the work you wish to insure. Please provide details of your experience and any courses you may have undertaken.* Has the business been established for more than 2 years and do you have more than 3 years industry experience in your practiced field? Yes No You have answered No to Has the business been established for more than 2 years and do you have more than 3 years industry experience in your practiced field? Please let us know what qualifications and/or experience you have in this field.* Is all your work carried out within Australia and subject to Australian Law?* Yes No You have answered no to not having all your work done in Australia. Please provide details below.* Do you undertake any work offshore or do you have offices outside Australia?* Yes No You have answered yes to undertaking work outside of Australia. Please provide details below.* Do you undertake any work of a manual nature including the training of others in manual tasks?* Yes No You have answered yes to doing work of a manual nature. Please provide details below.* Are you involved in any process of manufacture or construction?* Yes No You have answered yes to being involved in the process of manufacture or construction. Please provide details below.* Do you import or export any goods or products?* Yes No You have answered yes to importing or exporting goods or products. Please provide details below.* Do you provide any services to the following sectors:- Asbestos, Aviation, Chemical, Nuclear, Oil and Gas, Power Plants, Rail, Safety Critical or Financial Trading Platforms?* Yes No You have answered yes to providing services to the following sectors:- Asbestos, Aviation, Chemical, Nuclear, Oil and Gas, Power Plants, Rail, Safety Critical or Financial Trading Platforms? Please provide details below.* HiddenReview will be required*Due to some of your answers, your policy will be sent for review Your Policy Start Date - Past ClaimsHas any proposal in respect of the risks to which this form relates ever been declined or has any such insurance ever been cancelled or renewal refused?* Yes No Has any claim been made against the Proposer or any principal, partner, director, consultant or employee in respect of the risks to which this proposal relates?* Yes No You have answered yes to has any proposal in respect of the risks to which this form relates ever been declined or has any such insurance ever been cancelled or renewal refused?* You have answered yes to a claim being brought against you from your performance of business activities. Please provide more details below.* Is any principal, director, partner, consultant or employee of the Proposer, after enquiry, aware of any circumstances which might give rise to a claim against the Proposer or his/her predecessors in business or any of the present or former partners, principals, directors, consultants or employees?* Yes No Has the proposer, principal, director or partner ever been declared bankrupt or subject to any form of insolvency administration (e.g. liquidation or receivership) or been convicted of a criminal offence?* Yes No You have answered yes to being aware of a claim being brought against you, your predecessors, employees or consultants. Please provide more details below.* You have answered yes to being declared bankrupt or subject to any form of insolvency administration. Please provide details below.* HiddenReferral required3*Due to some of your answers, your policy quote will be sent for ReviewBusiness DetailsInsured Name (Legal Entity Name)* Telephone*Contact Name* Email* Date Of Establishment* DD slash MM slash YYYY Website HiddenCountry of Registration* ABN*Address* Physical Street Address of Business (Do not use a PO Box) Suburb State Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Details of interested parties to be noted Due to some of your answers, your policy will be sent for review Your Policy Start Date - Your Quote Your total annual premium based on the provided information is:HiddenQuote Amount Save QuoteDue to some of your answers, your policy will be sent for ReviewYour Occupation may be subject to endorsements and these can be read in full by using the "Save Quote button" above which will email the full quotation, provide access to the policy wording and include a link to return to this quote in the next 30 days.Important Notices Financial Services Guide Important Notices 1 Important Notices 2 Financial Services Guide PLEASE READ THE FOLLOWING ADVICE BEFORE PROCEEDING TO COMPLETE THIS PROPOSAL FORM* I have read and understood the IMPORTANT NOTICES and FINANCIAL SERVICES GUIDE I/We declare that the statement and particulars in this proposal form are true and that no material facts have been misstated or suppressed after enquiry. I/We agree that should any of the information given by us alter between the date of this proposal and the inception date of the insurance to which this proposal relates, I/We will give immediate notice thereof. I/We agree that the Underwriters may use and disclose our personal information in accordance with the Privacy Statement included in the IMPORTANT NOTICES of this Proposal. I/We agree that this proposal, together with any other information supplied by me/us shall form the basis of any contract of insurance affected thereon.HiddenBroker Declaration* I confirm that the answers provided by the Insured are true and correct and shall be the basis of this contract. TO BE SIGNED BY THE INSURED FOR WHOM THIS INSURANCE IS INTENDED FOR* ELECTRONIC SIGNATURE ACKNOWLEDGEMENT Date* DD slash MM slash YYYY Authorised Officer or Director* First Last It is important the undersigned of the declaration above is fully aware of the scope of this insurance so that these questions can be answered correctly. If in doubt, please contact the broker or agent, since non-disclosure may affect an insureds right of recovery under the policy.HiddenPlease confirm the Start Date of your Insurance* DD slash MM slash YYYY * I confirm the Start Date of Policy Please allow up to 60 seconds for your policy to be progressed and do not click the next button more than once. Your Policy Start Date - HiddenPolicy Needs Review Select payment type* Credit Card - Annual amount in full via credit card Please select the relevant payment type to continueRebalance price Price: $ 0.00 Policy Total Amount Price: $ 0.00 Subtotal $ 0.00 Total Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 CVV Cardholder Name Please allow up to 60 seconds for your policy to be submitted and do not click the submit button more than once.HiddenPremium Funding Interest chargeHiddenPremium Funding Interest RateHiddenPremium Funding TotalHiddenPremium Funding Initial InstalmentHiddenPremium Funding InstalmentPremium Funding Details Your first instalment is . There are 11 instalments remaining each of . These are payable monthly on the same day of each month. Premium: Interest Charges: Total Amounts Repayable: No. of Instalments: 12 Interest Rate: % Initial Instalment: Subsequent Instalments: These amounts are only estimates. To see an accurate pricing schedule HiddenRenewal Link* Hiddenefund link Hiddenefund PDF Bind acknowledgement* I acknowledge that clicking BIND will bind a policy