Insurance

Retail Shops

Restaurants

Takeaways

Light Non-Hazardous Commercial

Franchise Groups/Retail Chains

World Insurance Network merges with Insbroke Services and Ausnet Underwriting to create
Winsure Insurance Group.

Download Press Release

Winsure Website

Online Insurance Quote

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1. Broker's details

Company

Contact

Your email address

Your fax number

2. Your clients details

Insured name

Trading as

Situation of risk

Contact name

Phone number

Fax number

Occupation

How long in business?

years

Other tenants

3. Building

Construction

Walls

Roof

Frame

Floors

No of storeys

Age of building

Last rewired

Fire protection

Sprinklers	Yes No
Hose reels	Yes No
Smoke detectors	Yes No
Fire extinguishers	Yes No

Other fire protection
give details

Burglary protection

Deadlocks on ext. doors	Yes No
Keylocks on ext. doors	Yes No
Bars / grills on windows	Yes No
Back to base alarm	Yes No
Back to base security	Yes No
Local alarm	Yes No
Ext. roller shutters	Yes No

Other burglary protection
give details

4. Claims history Last 5 years

This year

Last year

Two years ago

Three years ago

Four years ago

Have you ever been declined insurance?

Yes No

If yes
give details

Other information
Cooking, deep frying etc

5. Previous insurers

Insurer

Premium

6. Fire details

Building