up to $250,000$250,001-$500,000
$1,000,000$2,000,000$5,000,000
$10,000,000$20,000,000
YesNo
123456+
In respect to gross fees/income for the last financial year, please provide a breakdown by state.
Note: We do not provide cover for any work performed under or claims arising out of the Jurisdictions of United States of America, Canada or their protectorates.
I hereby declare that I am / we are a Capital Gains Tax small business entity (within the meaning of section 152-10 (1AA) of the Income Tax Assessment Act 1997 of the Commonwealth). I am a small business individual / partnership / company and / or trust, which is carrying on a business, and the business has an aggregated turnover of less than $2 million
I/We Declare
Have any claim(s) been made against your business or any partner, principal or director or any related entity to the Insured for professional negligence, error or omission, or related matters in the past 5 years?
Does the insured provide any Information Technology Products or Services involving any of the following;
Claims are never pleasant when they occur, however AMGI is here to help! With fast, decisive action we can assist to get you back on track ASAP .
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Aviation Marine General Insurance Pty Ltd (AMGI) endorses the Insurance Brokers Code of Practice. To obtain a copy of the code click here.
Aviation Marine General Insurance Pty Ltd (AMGI) | ABN: 82 619 631 579 | Authorised Representative No: 1255492
Authorised Representative of PSC Connect Pty Ltd
ABN 23 141 574 914 AFS License No 344 648
