MACHINERY INSURANCE
Excavators & Earthmovers
AUSTRALIA HEAVY MACHINERY AND PLANT INSURANCE
NSW • QLD • WA • VIC • SA • NT • TAS
IronGuard Machinery & Plant Insurance - Truck Quote Form   Ph: 13-7442 Toll Free
Insurance Quote Form

Section 1Vehicle(s) To Be Insured

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

HideVehicle #1
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #2
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #3
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #4
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #5
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #6
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #7
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #8
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #9
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
HideVehicle #10
Type of Machine
Describe Your Machine
Make & Model
Year Manufactured
What state or territory is the machine mostly situated
Registration number (if registered for road use)
For what purpose is the is the vehicle primarily used for
Describe your mixed goods usage
Describe your packed hazardous & dangerous goods usage
Describe your hazardous & dangerous goods usage
Describe your vehicles usage
How much would you like to Insure this machine for - Sum Insured
Is this vehicle 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
General Questionaire Section 2
Do all vehicles proposed for insurance conform to all statutory requirements and regulations
Yes No
State the details
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 - Contact Details Section 4
ACN/ABN
Length of time in business
State of Australia where truck 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