Fine Arts Insurance Questionnaire - Insurance Broker Melbourne

General Details
Your name and trading name*
Address*
Street Address City State Postcode
Telephone
Fax
Email*
Website
How long have you traded from this business?
Years
Months
Previous address?
Years
Months
Please indicate which Trade Association you are a member of (if any)
Do you keep books recording all goods consigned or sale and/or valuation?*
- Yes
- No
Have you previously been insured?*
- Yes
- No
If YES, with whom?*
Have Lloyds or any other Insurer ever cancelled or refused o issue or to continue with any insurance for you?*
- Yes
- No
If YES, please provide details:*
Have you or any Director or Partner ever been:
Conviceted of or charged (but not yet tried) with any criminal offence*
- Yes
- No
Declared Bankrupt or Insolvent?*
- Yes
- No

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Sums Insured
STOCK, GOODS IN TRUST
Basis of Settlement: Claims under this Section are normally settled on the following basis :
- Own stock, at Original Cost Price + % OR Selling Price less 25% (Please indicate your requirement)
- Property sold but not delivered, at Selling Price
- Work on consignment - At Artist price + 20%, 30%, 40% (please select as appropriate)
- Property bought by you on behalf of a client, at purchase price plus any fee or commission pre-agreed in writing
With the above basis of Settlement in mind, what Stock Sum Insured do you require?*
With the above Sum Insured in mind, please indicate the percentage breakdown of your stock: Total: 100%
Pictures and the like (including frames)
Pottery, China, Glass, Terracotta & other brittle articles
Any other Stock (Please State)
Goods in Transit:
What value do you require for Goods carried by you away from your premises?
Maximum value, any one consignment within Australia by carriers, couriers regularly used for transits
Maximum value, any one consignment Overseas by carriers, couriers regularly used for transits
Do you require cover for Stock at Fairs / Exhibitions?*
- Yes
- No
If YES, please indicate:
Estimated number to be attended in the next 12 months
The maximum value taken to each

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General Details