First Name*
Last Name*
Email*
Phone
Residential Address*
Purchaser Details
Business/Company Name* (please include any trusts) e.g. ABC Pty Ltd ATF ABC Family Trust
ABN
Property Address
Tenacy
Gross Income
Gross Area
Net Lettable Area
If you are uploading a valuation or insurance survey, please select “refer to attached docs” as all information will be provided within
Roof material —Please choose an option—refer to attached docsConcreteMasonryTiles/SlateAsbestosFibroIron/Steel/Aluminum on steelIron/Steel/Aluminum on woodExpanded Polystyrene EPSWoodPolystyreneGlassOther/Mixed (Non Combustible)Other/Mixed (Full/Partial Combustible)
Floor material —Please choose an option—refer to attached docsConcreteIron/SteelBrickWoodOther/Mixed (Non Combustible)Other/Mixed (Full/Partial Combustible)Tile
Walls & Interior material —Please choose an option—refer to attached docsConcrete/StoneConcrete Tilt SlabIron/Steel/Aluminum on steelIron/Steel/Aluminum on woodBrickMasonryExpanded Polystyrene EPSWoodMixed < 75% Brick/Concrete/Iron on steelMixed > 75% Brick/Concrete/Iron on steelGlassMetalPolystyreneOther
Approx. Build Year
Number of Stories
Fire Protectionrefer to attached docsNoneSprinklersHeat DetectorsFire BlanketsFire ExtinguishersSmoke Detectors-MonitoredFire alarm Hose ReelsSmoke Detactors - Non MonitoredMonitored base alarm
Security Protectionrefer to attached docsNoneDeadlocks on doorsElectronic key pad/swipe card accessLocks on all external windows without barsBollards infront of glazing/display windows/roller shuttersLocal alarmWatchman patrolsBars on windowsProtection of Display WindowsSecurity fencingCCTV system installedExtenal LightingRoller ShuttersMonitored base alarm
Interested Party (mortgagee)
Claims history in the past 5 years
Service Information
Our intention at Rethink Property Insurance is to establish lasting relationships with our clients and offer the highest level of service as possible.
What is your preference for communication? PhoneEmail
What is priority for you when using an insurance broker?ServicePricePolicy Education
If there is one thing that your existing broker could improve, what would it be?
Upload Files*
(Upload a copy of your current insurance schedule/ paperwork, and any other materials that might assist us, such as marketing material etc.)
