Labour Hire Insurance Get A Quote

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Fortix ID Opportunity

Your Details

Name*

Company / Business Name

ABN

Best Contact Number*

Email*

Website

Address of Main Office*

About the Business

Is the business a registered Company?*

Yes
No

Please provide details of the Directors of the Company*

When did the business start trading?*

Less than 1 year ago
2 to 5 years ago
More than 5 years ago

Please provide details of Principal / Directors previous experience

Is the business registered as a Labour Hire Company?*

Yes it is
No, it does not need to
No it is not
Unsure

If yes, please provide registration details*

Staff Details

Do you have?*

Internal Employees
On-Hired Employees
On-Hired Contractors

Which describes your on-hired Contractors?*

Sole traders or single director Pty Ltd companies
Companies or sole traders with their OWN EMPLOYEES
A combination of both
Other (please specify)

If other, please specify additional information*

Number of all Staff (Internal & On-Hired plus Directors) & On-Hired Contractors by location

VIC

NSW

QLD

WA

SA

NT

ACT

TAS

Overseas

Your Business Activities

What Recruitment & Consulting Services do you provide?*

Temporary placement of Employees and Contractors for the provision of On-Hired Services or On-Hired Medical Services
Placement of candidates in permanent positions
Employment consulting services as a service separate to temporary and permanent placements
Training and induction, including group training
Payroll management for Employees and Contractors.
Other Services not listed above

Placement of Permanent Candidates

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Employment Consulting Services

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Training & Induction Services

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Payroll Management for Employees and Sub-Contractors

Turnover for past 12 months*

Estimated Turnover for next 12 months*

On-Hired Labour

Do you on-hire*

White Collar
Blue Collar

Please tick all white collar occupations that apply.

Clerical / Secretarial

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Hospitality

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Architects

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Accountants

If new business, please enter 0*

Estimated Turnover for next 12 months*

Engineers

Turnover for past 12 months*

Estimated Turnover for next 12 months*

IT Consultants

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Communications

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Other Professionals

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Nurses / Healthcare Workers

Will their be an midwifery or childbirth services?*

Yes
No

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Childcare Workers

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Other Workers

Please provide overview of other workers*

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Please tick all blue collar occupations that apply.*

Welding

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Electrical

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Mechanical

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Plumbing

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Drivers

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Stores

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Food Processing

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Mining - Above Ground

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Mining - Below Ground

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Construction

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Construction - Civil

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Marine

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Aviation

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Retail

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Other Services

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Please provide overview of other workers*

Other Recruitment Services - Not Listed Above

Turnover for past 12 months*

Estimated Turnover for next 12 months*

Please provide overview of other workers*

Overall Turnover

Total Business Turnover for past 12 months*

Total Business Turnover Estimated for next 12 months*

Risk Management

Do you assume any liability under contract?*

Yes
No
Unsure

Do you undertake business outside of Australia?*

Yes
No
Unsure

If yes, please provide further details.*

Is any work performed by you or on your behalf within any offshore platforms and/or rigs?*

Yes
No
Unsure

Is any underwater work performed by you or on your behalf?*

Yes
No
Unsure

If yes, please provide further details.*

Are there any subsidiary companies that need to be insured?*

Yes
No

If yes, please provide further details.*

Insurance Required

Are you currently insured?*

Yes
No

Please provide renewal date & current insurer*

Professional Indemnity Insurance

Level of Cover Required*

If other, please advise limit?*

Public Liability Insurance

Level of cover required?*

If other, please advise*

Management Liability Insurance

Is Management Liability Insurance Required?*

Yes
No

Management Liability cover protects a business against mismanagement. Claims that can arise include unfair dismissal, intellectual property breach, fines & penalties, fidelity and tax audit cover.

Type of Company*

Private Company
Public Company
Incorporated Association
Other

Total Asset value of the company*

Total Profit (or loss represented by brackets) of the company*

Level of cover required?*

If other, please advise*

Do you require Employment Practices Liability*

Yes
No
Unsure - Need More Details

If yes, please provide limit of cover required*

Business Financials

Please attached, if available, a copy of the past 2 Annual Financial Statements

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB, Max. files: 5.

If no financials are supplied, the policy will be subject to an insolvency exclusion.

Disclosure Questions

The term YOU in the questions below relates to your Firm, Company, Subsidiaries or you as a Sole Practitioner including present or former Partners, Directors, Principals, Consultants, or Employees.

Are YOU being operated under any type of third party agreement?*

Yes
No

Have YOU had any Professional Indemnity, Public Liability or Management Liability insurance refused, declined, cancelled or had special conditions imposed by an insurer?*

Yes
No

If Yes, please provide further details*

Have YOU had a claim or received a notification of a claim in the past 5 years?*

Yes
No

Have YOU been charged with or convicted of any criminal offence?*

Yes
No

If Yes, please provide further details*

Have YOU been declared bankrupt, insolvent, had a liquidator appointed or been a defendant in any civil court case?*

Yes
No

If Yes, please provide further details*

Other Insurances

Do you require a quote or further information about any of the following insurances?

Cyber Insurance
Business Insurance
Motor Insurance
Workers Compensation
Life Insurance
Income Protection
Other Insurance

If other, please advise

Additional Information

Is there any other information that you need to provide to the insurer?*

YES there is
No there is not

Do you have any further information to provide?*

How did you hear about Webber Insurance?*

Web Search
Referred by Someone
A Building Designer Association
Social Media
Previous / Existing Client
Other

If other, please advise*

We appreciate referrals. Please let us know who provided you with our details*

Important Information

Please take a moment to read these important documents prior to submitting your form.

Declaration

I/WE declare that we have read the important notices attached above and I/WE understand those notices.
I/WE undertake to inform insurers of any material alteration to these facts whether occurring before or after completion of the Contract of Insurance.
I/WE hereby acknowledge that the insurance cover may be provided in whole or in part by overseas insurers.

Please tick all to confirm that you have read the following documents:*

Privacy Policy
Financial Services Guide
Duty of Disclosure
Terms of Engagement

Signature

This electronic signature will be treated the same as if signed personally.

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Labour Hire Insurance Quote Request

Your Details

About the Business

Staff Details

Number of all Staff (Internal & On-Hired plus Directors) & On-Hired Contractors by location

Your Business Activities

Placement of Permanent Candidates

Employment Consulting Services

Training & Induction Services

Payroll Management for Employees and Sub-Contractors

On-Hired Labour

Clerical / Secretarial

Hospitality

Architects

Accountants

Engineers

IT Consultants

Communications

Other Professionals

Nurses / Healthcare Workers

Childcare Workers

Other Workers

Welding

Electrical

Mechanical

Plumbing

Drivers

Stores

Food Processing

Mining - Above Ground

Mining - Below Ground

Construction

Construction - Civil

Marine

Aviation

Retail

Other Services

Other Recruitment Services - Not Listed Above

Overall Turnover

Risk Management

Insurance Required

Professional Indemnity Insurance

Public Liability Insurance

Management Liability Insurance

Business Financials

Disclosure Questions

Other Insurances

Additional Information

Important Information

Declaration

Signature