Trade Liability Insurance - Online Proposal Form

 

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Name of Dive Centre
Postal address
Day time phone number
Fax number
Email address

 

Locations where you do business


Nature of Business


Previous claims history

Please provide a breakdown of turnover
Currency is in Australian Dollars

Dive Training $
Retail Sales/Servicing $
Other Income $

Specification of other income


Is the Centre owned by a USA company?

Total annual turnover $
Number of employees
Annual wage roll $

Interested Parties to be noted as Co-Insured

Names of Instructors


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