Formal Quote Request 1 Types of cover2 Details of cover3 Disclosure questions4 Contact information I'm interested in Public Liability (click to see optional add-ons) Choose optional add-ons*Add-on products cannot be taken out separately.Public Liability - No Add-onsPublic Liability + General Property Add-onPublic Liability + General Property Add-on + Electronic Equipment Breakdown Add-on Trailer Air and Sea Shipping Other (Custom Quote) Public LiabilityHow many photo booths are used in the business?*Between 1-3Between 4-6Between 7-10More than 10Have you imported any of your photo booths from overseas?*NoYesIf "yes", from which countries and how many of your booths?*About Your Products (products exported to USA / Canada are not covered) Do you sell, distribute, or hire out any other products or services that are not specific to the photo booth industry? (eg DJ, Photography, Videography)*NoYesIf "yes", please specify:* DJ Photography/Videography Other Please give details of how many DJ stations you operate:*Number of DJ related staff:*Approximate annual turnover of DJ related activities:*Please give details of how many photography and/or videography set ups you have:*Total number of Photography/Videography related staff:*Approximate annual turnover of Photography/Videography activities:*Please provide details of the "Other" activity, the number of staff involved and the approximate turnover of this activity:*Do you manufacture, pack or relabel any products which you sell or distribute?*NoYesIf "yes", please provide details incl % of turnover:*Do you import products or goods?*NoYesIf "yes", from which countries:*Property in your physical and legal control This policy automatically provides third party property cover to $250,000 (subject to conditions - see policy).*AcknowledgedDo you have property belonging to others in your physical and legal control?*For example, borrowing a booth or other property from someone.NoYesIf "yes", please describe that property:*Is $100,000 of third party property cover adequate?*YesNoIf "no", what limit do you require?*Public Liability Limit Desired limit of indemnity$10,000,000$20,000,000Quote me for both Add-On: General Property This cover cannot be taken without Public Liability cover. Cover is limited to booths and equipment up to 15 years old.Portable and Valuable Items*The following items and their accessories must be individually described including make and model.Specified ItemSum Insured $MakeModel Add-On: Electronic Equipment Breakdown This cover cannot be taken without Public Liability cover and General Property cover. Cover is limited to equipment up to 10 years old.Electronic Items*Electronic items must be individually listed including replacement value, make and model.Specified ItemReplacement Value $MakeModel Trailer Trailers*Trailers must be individually described including make/model, year built and value.Make/ModelBuild YearValue $ Your date of birth* MM DD YYYY Trailer's Registration Number*What is the legal ownership status of your trailer?*OwnedFinancedIf "financed", please give details of the financial institution (incl. address):*In the last 5 years, have you or any other person likely to drive these vehicles had a claim, accident, or car stolen or burnt (even if not reported or not claimed from an insurer)?*NoYesIf "yes", please provide details:*In the last 5 years, have you or any other person likely to drive these vehicles had insurance refused, declined, or cancelled by an insurer or any special conditions imposed?NoYesIf "yes", please provide details:* Air and Sea Shipping Note: For overseas originating transit only. Transit which originates in Australia is included as part of "General Property" cover. Import Events*Each import event must be individually described including country of import, destination, and indemnity value. Indemnity value is determined by: purchase cost plus shipping plus 10%.Country of ImportDestinationIndemnity Value Custom Quote If you require any insurance outside of the photo booth industry, please provide details of your other business activities.* Within the last 3 years, have you (or any insured party) had more than 3 claims or incidents that could have resulted in a claim or an overall claims/incidents value greater than $10,000? (excluding claims already lodged against this policy number)*NoYesIf "yes", please provide details:*Have you (or any insured party) ever had a claim declined or refused or insurance refused due to fraud, suspected fraud or suspicious circumstances?*NoYesIf "yes", please provide details:*Are you (or any insured party) currently bankrupt?*NoYesIf "yes", please provide details:*Within the last 5 years, have you (or any insured party) been charged or convicted of a criminal offence?*NoYesIf "yes", please provide details:*Acknowledgements I acknowledge that Booth Cover*Does not cover photo booths or any equipment not made by a recognised professional manufacturer unless specifically agreedI acknowledge that Booth Cover*Does not provide cover for photo booths imported from China unless specifically agreed. Business Details Name of Insured/Entity Name*Business NameABN or ACNAre you running a photo booth only business?*YesNoIf "no", please describe the nature of your business:*What is the legal ownership status of your photo booths and other equipment?*OwnedFinancedIf "financed", please give details of the financial institution (incl. address):* Contact Details Name* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country How did you hear about Booth Cover?Please chooseGoogleOther search enginePhotobooth FinderBoothConFacebookOther social mediaBooth manufacturerIndustry supplierIndustry colleagueWhich booth manufacturer or supplier?Please chooseThe Wilkes Booth CoRed RobotPhotosnapThe Booth BoxSocial PlaygroundPaparazzi StudiosBlue Steel BoothsPhootbooth EmporiumCre8ive Booth SuppliesProfile ProductsBoomerang PropsJA Davey / DNPHiRes Photo PrintingCashGroup.com.auOtherAnything else you would like us to know?Please Confirm* I have read the Duty of Disclosure and Co-Insurance (Average) Clause NameThis field is for validation purposes and should be left unchanged. 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