Investment Property Form

Your Details

Full name: (incl Title) *

Contact telephone number: *

Email address: *

Property Details

Property address: *

Postcode: *

Commercial or residental:*

If commercial, list tenant occupations:

Annual rent:

Building type:*

Year built:*

Year last rewired:

Walls:*

Insurance Requirements

Buildings sum insured:

Fixtures and fittings:

Loss of rent:

Public liability:

Please provide full details of any claims made and/or losses suffered under previous under a similar Investment Property Insurance policy during the past 5 years (whether or not a claim was made):*

If none, please state

Please use this box to provide any further information that may be relevant to your Investment Property Insurance policy:

Current Investment Property Insurance policy provider: *

If none, please state

Current Investment Property premium: *

If none, please state

Renewal date of existing insurance / date cover to start (as applicable): *

NB: Cover is not in force until agreed upon by the company

Contacting You

Are you an existing Bruce Insurance customer? *

yesno

Preferred contact method: *

Preferred contact time:

How did you hear about us? *

Bruce Insurance is a trading name of Bourchier Nominees Pty Ltd. We would like to contact you from time to time about products and services (or with news, offers and promotions) that we feel may be of interest to you. By providing us with your contact details, you consent to being contacted by these methods for these purposes.

Please tick the box if you prefer to not receive marketing communications from us by post or telephone.

Please tick the box if you prefer to not receive marketing communications from us by email, text messaging or other electronic means.