Step 1 of 4 - Select Land Size and Structures for Quote 25% Office Email Address to receive policy documents and expiry notifications* Quote / Apply Now*Select your land sizeVacant Land not greater than 1,000 square metres in sizeVacant Land not greater than 2,500 square metres in sizeVacant Land not greater than 1 acre in size (4046 sqm / 0.4046 hectare)Vacant Land not greater than 5 acres in size (20,234 sqm / 2.0234 hectare)Vacant Land not greater than 10 acres in size (40,468 sqm / 4.0468 hectare)Vacant Land not greater than 20 acres in size (80,937 sqm / 8.0937 hectare)Do you have or do you expect to have any buildings or structures on your land within the first 3 months of this policy period?* Yes No Empty pool, shed, vacant dwelling pending demolition, building under construction or other? See options for additional cover here.We will cover your liability exposure associated with owning any of the following buildings or structures; Vacant and Unoccupied Dwelling pending demolition or sale Sheds, Carports, Garages, Shipping Containers on Vacant Land Land with building under construction by building contractor or company with an active construction liability insurance policy Vacant Land with an empty and fenced swimming pool Policy Start Date DD slash MM slash YYYY Policy Expiry Date DD slash MM slash YYYY Your total annual cost is $ 0.00 To qualify for a landcover policy, read and answer these 3 questions1) Have you read and do you accept the Landcover Terms and Conditions?View Terms and Conditions Yes No 2) Apart from any options for structures already selected, is your block of land 'Vacant' in accordance with the Landcover definition of Vacant land?* Yes No DEFINITION OF VACANT LAND AND STRUCTURES Vacant Land, for the purpose of this insurance means: Land not being used for any business (other than as property owner), profession, trade, manufacturing, or rural activity or operation. Such land to be with or without any of the following: gates, fences, letter boxes, site identification pegs and signs. plants, trees and shrubs. landscaping, retaining walls, gutters, drains, paths, paving and driveways. underground and above ground services including aprons, supply mains and meters, water tanks ,bore pumps and housings. Structures for the purpose of this insurance means: Vacant Land with unoccupied dwelling pending demolition or sale. Vacant Land with sheds / carport's / garages / shipping containers. Vacant Land with building under construction by building contractor / company with an active construction liability policy. Vacant Land with an empty and fenced swimming pool. More than one of the above structures may be applicable.3) To your knowledge has the land at anytime been used for landfill, dumping of rubbish refuse or waste, classified as a contaminated site or used by aircraft or have railway lines or sidings on the land?* Yes No The Following details are required to ensure the policy is allocated to your brokerage account. Name of BrokerageBroker ABNBroker AFSLIs this Policy application is being made by an AR* Yes No AR ABN*AR ASIC No*AR Name*AR Email* Insured Parties(this is the name that will appear on your policy. It can be first name(s) & surname(s), a business or trust etc ++ numbered community title, superannuation fund etcName of Insured*Land Address(the land to be insured)Land Address* Lot Number or Street Number Street Name Suburb State Select StateAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postcode Any Additional/Interested parties?* Yes No Close your Additional / Interested party to be noted* Financier Lessor Stipulated by Contract or Agreement Additional /Interested parties(e.g Financier/ Mortgage)Contact details of the person completing this applicationName* First Name Surname Email Address* Confirm Email* Mobile Phone*Landline (incl. area code) Your Total Premium inc GST $ 0.00 Please review your details before payment Policy Details Selected Land Size: {:37} ({:37:currency}) Options Selected: Applicant Details/Insured parties Name of Insured {Name of Insured:12} Land Address Lot Number or Street Number {Land Address (Street Address):14.1} Street Name {Land Address (Address Line 2):14.2} Suburb {Land Address (City):14.3} State {Land Address (State / Province):14.4} Postcode {Land Address (ZIP / Postal Code):14.5} Interested Parties {Interested parties:32} Contact details of the person completing this application First Name {Name (First):16.3} Surname {Name (Last):16.6} Email Address {Email Address:17} Mobile {Mobile Phone:20} Landline {Landline (incl. area code):18} This field is hidden when viewing the formBase PremiumThis field is hidden when viewing the formBase Premium GSTThis field is hidden when viewing the formBase Premium TotalThis field is hidden when viewing the formStamp DutyThis field is hidden when viewing the formStamp DutyThis field is hidden when viewing the formStamp DutyThis field is hidden when viewing the formStamp DutyThis field is hidden when viewing the formNet PremiumThis field is hidden when viewing the formNet PremiumThis field is hidden when viewing the formNet PremiumThis field is hidden when viewing the formNet PremiumThis field is hidden when viewing the formTotalThis field is hidden when viewing the formAdmin FeeThis field is hidden when viewing the formAdmin FeeThis field is hidden when viewing the formAdmin FeeThis field is hidden when viewing the formAdmin FeeThis field is hidden when viewing the formAdmin Fee GSTThis field is hidden when viewing the formAdmin Fee GSTThis field is hidden when viewing the formAdmin Fee GSTThis field is hidden when viewing the formAdmin Fee GSTPolicy NumberCommentsThis field is for validation purposes and should be left unchanged.
