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Ford Kinter

Head Office:

1 - 3 Smolic Crt, Tullamarine,
Victoria 3043, Australia

PH. (03) 9339 3333
Fax. (03) 9339 3355

Toll Free 1800 810 392

info@fordkinter.com.au

Farm Quotation Form

FARM QUOTATION FORM

Please fill in the details below for a quotation or click here for us to contact you


Fields marked with an * are required fields.

Business Details
Business Name: *
Type of Business: *
No of years in business: *
No of employees: *
Annual wages paid: *
No of locations: *
Annual turnover / sales: *
Age of building: *
Building made primarily of:
Fire protection:
Details of claims
made in the last 5 years:
Have you ever been declined or had insurance cancelled?
Yes  
No  

If yes please give details:

Have you ever been charged or convicted of a criminal offence?
Yes  
No  

If yes please give details:

Fire Insurance
Buildings: *
Contents:
Replacement of records: *
Removal of debris: *
Other property: *
Loss of rent: *
Burglary Insurance
Stock:*
All other Content:
Business Interruption
Gross Income:*
Claims Preparation Costs:
Accounts receivable: *
Increase in working cost: *
Payroll: *
Money
In transit:*
In Building during
business hours:
In Building whilst
contained in locked
safe: *
At your / employees
residence: *
Damage to safe /
strongroom: *
Machinery Breakdown
Machinery, Plant,
Boilers & Pressure
Vessels:*
Electronic Equipment
New replacement cost:*
Electronic data
restoration costs:*
Increase in costs
of working:*
Broadform Liability
Public:*
Products:*
Glass
External:*
Internal:*
General property
Interest insured:*
Goods in transit
Interest Insured:*
Contact Details
Name:*
Company:*
Position:*
Postal Address:*
Suburb / Town:*
State:*
Postcode:*
Phone:*
Fax:*
Email:*
Comments:



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