Marine Trades Public & Products Liability Application

1. Applicants

The date you would like your policy to start*

The expiry date of your policy will be 4.00 p.m on*

Name/s (include “Trading As” if applicable)*

Postal address*

E-mail address*

Website address

Business telephone no.

Business or occupation*

Years in business

ABN

List all location address/es from which you operate, including postcodes

Other interested parties

Postal address/es

2. The Business

Please note your gross turnover from your business for the last financial year ($)*

Estimated gross turnover for the next 12 months ($)*

Do you engage subcontractors?*

Yes
No

Please indicate the amount of gross turnover paid to subcontractors ($)

Do you obtain evidence of liability insurance from subcontractors*

Yes
No

Number of qualified tradesmen employed by you*

Please indicate percentages (where applicable) which form part of the business.

a) Repairs and alterations (%)

b) Maintenance work (%)

c) Installation work (%)

d) Fit-out and refurbishment (%)

e) Painting and anti-fouling (%)

f) Rigging (%)

g) Detailing, cleaning and water blasting (%)

h) Hauling and/or lifting, operator of lifting / carrying equipment (%)

i) Slipping, slipway / dry dock operator (%)

j) Launching and sea trials (%)

k) Fuelling (%)

l) Berth / mooring owner / provider and occupier (%)

m) Premises occupier (%)

n) Provision of social / sports club canteen, first aid / medical / fire (%)

o) Maintenance of premises or ambulance services (%)

p) Car park operator (%)

If you undertake any of the following services and operations, please indicate percentages (where applicable) relating thereto that you wish to insure. The following services are not automatically insured and may be subject to additional terms and conditions and / or payment of an additional premium.

q) Hot work (%)

r) Storage (%)

s) Landlord (%)

t) Provision of utilities (%)

u) Brokerage and/or agency (%)

v) Retailer of chandlery and boating equipment (%)

w) Chartering (%)

x) Provision of weather and boating information (%)

y) Bar, club and restaurant operator (%)

z) Catering (%)

Any other services or operations undertaken not specifically stated above, must be declared below if you wish to insure for such services and operations. Please note that any such services and operations are not automatically insured and may be subject to addition terms and conditions and / or payment of an additional premium if we agree to provide cover.

3. Loss Prevention, Safety and Security

If you operate more than one location, please supply the additional information as an attachment

Do you operate more than one location?*

Yes
No

Are the premises?*

Owned
Leased

Are the premises? (Location 2)

Owned
Leased

Are the premises? (Location 3)

Owned
Leased

If leased, are you required to arrange material damage insurance in respect of the premises?

Yes
No

If others are occupying any of the premises owned or leased by you, please describe their business activities

Are the premises fully fenced?*

Yes
No

Do you employ 24-hour security staff?*

Yes
No

Do the premises have an intruder alarm?*

Yes
No

When was the last risk survey conducted at the premises?

Please attach a copy at the end of the form of the most recent risk survey if available

Are there any outstanding recommendations?*

Yes
No

What distance is the nearest Fire Station?*

Number of fire hydrants in close proximity to premises*

Number of fire extinguishers and hoses on premises*

Do the premises have any sprinkler systems?*

Yes
No

Are your fire precautions and equipment inspected annually by a third party?*

Yes
No

Are gas freeing operations carried out at the premises, and if so, who performs the gas freeing certification work?

Do you engage in hot work?*

Yes
No

If "Yes" please indicate where this work is performed, and whether all persons are required to comply with the Australian Standard (Safety in Welding & Allied Processes)?

Fuelling pipes (Number)

(Total capacity)

(Location of pipes)

Do you undertake any spray painting?

Yes
No

If "yes", do you utilise purposefully built spray booths?

Yes
No

If you answered "No", please provide further details

Do you discharge or dispose of trade wastes, smoke, soot, fumes, liquids, gases or other substances into the atmosphere, sewers, watercourse or elsewhere?

Yes
No

If “Yes”, is it by agreement with local authorities and are all wastes treated and made safe before discharge?

Yes
No

Do you have a business continuity plan?*

Yes
No

Please attach a copy at the end of the form.

4. Watercraft Specific Information

Description of watercraft services by you or using your facilities:

Construction

Maximum length

Tonnage

Maximum value

Maximum number at any one time

Maximum value any one time

Commercial watercraft (%)

Private watercraft (%)

If storage of watercraft is provided, please provide details of storage area, security in place and maximum number and maximum value of watercraft stored at any one time

5. Products Liability

Do you sell any watercraft?*

Yes
No

If "Yes", please provide details of make of watercraft and number held for sale at any one time

Maximum value of watercraft held by you for sale ($)*

Radius of use from premises during demonstration*

Do you insist that purchasers obtain an independent survey prior to sale*

Yes
No

Do you sell any chandlery or other watercraft products?*

Yes
No

If “Yes”, please indicate the percentage of turnover derived by you below:

Manufacturer (%)

Importer (%)

Wholesaler/Distributor (%)

Retailer (%)

Exporter (%)

Do you export any products to the United States or Canada or their protectorates or territories?*

Yes
No

If "Yes", please indicate turnover derived by you from such exports*

Please note other countries products are exported to or imported from:

Exported

Imported

If you manufacture your own products, please provide details including who designed or formulated them

Are the finished manufactured products subject to any Australian Standards Association codes or relevant international codes?*

Yes
No

If "Yes", please provide details

Please describe methods of quality control adopted by you

You will need to upload the following documents at the end of this application:
Product brochures in respect of products manufactured by you

6. Contractual Relationships

Do you incorporate any of the following contractual agreements or similar into your dealings with your customers:

Please provide copies of all these agreements including any not noted below

Standard terms and conditions
Products sales invoice
Slipway agreements
Storage agreements
Customer specific contracts
Watercraft bill of sale
Racing / training disclaimers
Berth / mooring agreements
Standard subcontractor agreements

Have these contractual agreements been signed off or drafted by your solicitors, or are they based on standard terms published and recommended by recognised industry bodies?*

Yes
No
N/A

If yes, please state how you incorporate these contractual agreements into your dealings with customers / subcontractors

If you do not operate under any contractual agreements in relation to a specific service you provide, please provide us with your reasons for doing so

In respect of any products or watercraft distributed by you, but not manufactured by you, do you enforce any warranties or guarantees against the original supplier?

Yes
No

You will need to upload the following documents at the end of this application:
Please provide copies of any contractual agreements used with your customers.

7. Insurance

Please indicate level of cover sought:

Public Liability

$5m
$10m
$20m
Other

If other, please state how much

Products Liability

$5m
$10m
$20m
Other

If other, please state how much

You also have the option of insuring for optional additional cover, please indicate if you require:

Fines and penalties – Policy limit: $1m
Faulty workmanship – Policy limit: $25,000
Warranty / guarantee obligations – Policy limit: $25,000

8. General

Please advise who your current insurer is

When does your current insurance policy expire

Please provide full details of all losses or claims (whether insured or not) over the last 5 years

Current year (Date of loss, Brief description, Gross amount and Status)

Previous years (Date of loss, Brief description, Gross amount and Status)

9. Supporting Documents

Has any insurer at any time:

Declined your proposal for insurance?*

Yes
No

Cancelled or refused to renew your policy?*

Yes
No

Imposed special conditions / rates as a result of your policy history?*

Yes
No

If you answered “Yes” to any of the questions above, please provide details

Are there any other relevant facts to the risk to be insured which you should disclose to enable a true assessment of your application before acceptance?*

Yes
No

If “Yes”, please provide details

Please attach all supporting documents required:

Section 4 - Please provide product brochures in respect of products manufactured by you
Section 5 - Please provide copies of any contractual agreements used with your customers.

Note: You must combine all supporting documents into one file for upload.
On a Windows PC: Select the files you wish to zip, then right click > Send to > Compressed (zipped) folder
On a Mac: Select the files you wish to zip, then right click > Compress items

Attach File

Max. file size: 512 MB.

Note: you can also email required attachments to Simone.wells@oceanicmarinerisks.com.au

I/We declare that: a) To the best of my/our knowledge and belief the information provided herein is true and correct in every respect and I/we have not withheld any relevant information.*

Yes

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