MACHINERY INSURANCE
Excavators & Earthmovers
AUSTRALIA HEAVY MACHINERY AND PLANT INSURANCE
NSW • QLD • WA • VIC • SA • NT • TAS
IronGuard Machinery & Plant Insurance - Quote Form   Ph: 1300 620-520
Insurance Quote Form

Section 1Machine(s) To Be Insured

This Section will allow you to specify a multiple number of machines

HideMachine #1
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #2
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #3
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #4
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #5
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #6
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #7
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #8
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #9
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
HideMachine #10
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
Is the machine
Who is your current insurer - if you don't know leave it blank
Registration number (if registered for road use)
What state or territory is the machine mostly situated
How much would you like to Insure this machine for - Sum Insured
Is this machine currently Insured
Yes No
Who is your current insurer - if you don't know leave it blank
Do you require Third Party liability Insurance
Yes No
Specity the amount of cover you require
Please specify the amount of cover you require
Is the machine (or any part thereof) to be insured:
a. in any way defective
Yes No
State the details
b. required repair in the last 5 years - other than maintenance or non-structural repairs
Yes No
State the details
c. more than 20 years old, or not in current production
Yes No
State the details
d. regularly serviced and maintained in good order
Yes No
State the details
e. Will the machine be used for purposes other than for which it is specifically designed
Yes No
State the details
f. Will the machine be hired out without your own operator
Yes No
State the details
g. Have any of the operaters of the machine had less than 12 months experience operating it
Yes No
State the details
Note: When a person operating or in charge of a machine has less than 12 months experience on that particular machine or a similar machine the Claim Excess may significantly increased.
Under what conditions will the machinery operate:
a. Underground
Yes No
b. Over or near water
Yes No
c. Demolition
Yes No
d. Scrub / Timber clearing or logging
Yes No
e. Agriculture or farming
Yes No
f. Lifting
Yes No
g. Mounted and / or transported on any form of floating vessel
Yes No
h. Any other activity which may be considered hazardous
Yes No
State the details
i. Has the machinery been fitted with any anti-theft or vandal proofing devices or fire suppression equipment
Yes No
State the details
General Questionaire Section 2
Does all machinery proposed for insurance conform to all statutory requirements and regulations
Yes No
State the details
Where a machine is used for lifting, is a load-limiting device fitted
Yes No
Before a person begins employment with you, do you ensure that:
a. they have a current driver/operator certificate of competency as required by state regulation or law
Yes No
State the details
b. they have acceptable credentials and history of employment which are verified by you
Yes No
State the details
c. they are fully conversant with manufacturers manuals and all relevant statutory requirements
Yes No
State the details
Period Of Insurance Section 3
When would you like the quote for insurance start - most policies run for 12 months
When would you like the Insurance to end if less than 12 months
Applicant(s) - Contact Details Section 4
ACN/ABN or Business Registration Number (if applicable)
Length of time in business
State of Australia where machinere is usually kept
Preferred method of contact       Phone Email


Declaration Section 5
Has the Owner or the Person requesting this Quote ever:
a. been refused insurance cover
Yes No
Name of insurer
Date
Details of action taken by insurer
b. had an insurance claim of any type refused or reduced
Yes No
Name of insurer
Date
Details of action taken by insurer
c. Irrespective of whether a claim was made, during the past five years have you sustained a loss by any of the risks againt which you propose to insure
Yes No
Details
d. Have you or any person who will receive insurance protection under the proposed policy been charged with, or conviced of any criminal offences in the past 10 years
Yes No
Details of charge, prosecution, penalty, fine or bond