Professional Indemnity API VALUERS PROPOSAL FORM Please return this completed proposal to: Perrymans General Insurance Brokers PO Box 596, Kent Town SA 5071 Fax: 08 8362 3131 Email: api@perrymans.com If you have any queries please phone: 08 8362 7127
PLEASE READ THE FOLLOWING NOTICES BEFORE COMPLETING THIS PROPOSAL FORM Your Duty of Disclosure Contracts of General Insurance Before you enter into a contract of general insurance with an Insurer, you have a duty, under the Insurance Contracts Act 1984, to disclose to the Insurer every matter that you know, or could reasonably be expected to know, is relevant to the Insurer s decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to the Insurer before you renew, extend, vary or reinstate a contract of general insurance. Your duty however does not require disclosure of any matter: that diminishes the risk to be undertaken by the Insurer; that is of common knowledge; that your Insurer knows or, in the ordinary course of their business, ought to know; as to which compliance with your duty is waived by the Insurer. Non-Disclosure If you fail to comply with your duty of disclosure, the Insurer may be entitled to reduce their liability under the contract in respect of a claim and/ or may cancel the contract. If your non-disclosure is fraudulent, the Insurer may also have the option of avoiding the contract from its beginning. Change of Risk or Circumstances The terms and conditions of any insurance policy offered by the Insurer will be based on the information provided to the Insurer. If any material change occurs to the information provided on or with this proposal form prior to the inception of the policy, it is essential that the Insurer is advised of the same prior to inception of any policy. Failure to do so on your part may prejudice any subsequent claim under the policy and/ or the continuation of the insurance contract. Claims Made Policy Professional Indemnity Policy Any insurance contract (policy) that may be offered on the basis of this proposal form will provide insurance on a claims made basis. This means that the policy will indemnify you for claims made against you and notified to the Insurer during the period of insurance. The policy will also respond to the written notification of facts that might give rise to a claim pursuant to Section 40(3) of the Insurance Contracts Act 1984 which states; Where the insured gave notice in writing to the insurer of facts that might give rise to a claim against the insured as soon as was reasonably practicable after the insured became aware of those facts but before the insurance cover provided by the contract expired, the insurer is not relieved of liability under the contract in respect of the claim, when made, by reason only that it was made after the expiration of the period of the insurance cover provided by the contract. The policy does not provide indemnity in relation to: events that occurred prior to the retroactive date, if any, specified in the policy; claims notified or arising out of circumstances notified under any previous policy; claims made against you prior to the commencement of the period of insurance; claims made against you after the expiry of the period of insurance; claims arising out of claims or circumstances noted on this proposal form or any previous proposal form; claims arising out of any facts or circumstances known to you at the commencement of the period of insurance where such facts or circumstances would have put a reasonable person in your position on notice that a claim may be made against you in the future. The indemnity provided by the policy is subject to all the terms and conditions of the policy. Surrender or Waiver of any Right of Contribution or Indemnity Where another party would be liable to compensate you or hold you harmless for part or all of any loss or damage otherwise covered by the policy, but you have agreed with that party that you would not seek to recover any loss or damage from that party, you are NOT COVERED under the policy for any such loss or damage. Increased Contractual / Assumed Liabilities Unless otherwise agreed by the Underwriter/Insurer, Insurance policies EXCLUDE COVER in respect of:- any liability assumed by the Insured under a contract, including but not limited to any express guarantee, warranty, contractual penalty or liquidated damages, unless such liability would have attached to the Insured in the absence of such contract; or any duty or obligation assumed by the Insured that is not assumed in the normal conduct of the Insured business You should obtain appropriate legal advice before agreeing to or signing any such document. Not a Renewable Contract Any insurance policy offered by the Insurer will terminate at expiry of the specified period of insurance. There is no right to automatic extension or renewal of the policy. If you wish to effect similar insurance for a subsequent period, it will be necessary for you to complete a new proposal form prior to the termination of the expiring policy so that the Insurer may consider whether or not to offer a replacement policy, and if so, on what terms. Retroactive Liability The contract does not provide cover in relation to events that occur before the commencement of the contract unless retroactive liability cover is requested in this proposal form AND THE CONTRACT IS EXTENDED accordingly. If you require further explanation please contact our office. Average Provision One of the insuring provisions of the Professional Indemnity Contract of Insurance provides that where the amount required to dispose of a claim exceeds the limit of the sum insured in the contract the insurer shall be liable only for a part of the total costs and expenses which shall be the same proportion of the total expenses as the contract limit bears to the total amount required to dispose of the claim. Privacy Policy Perryman O Grady Philpott Pty Ltd trading as Perrymans is conscious of its obligations under the privacy legislation and regulations relating to the way we can collect, use, keep secure and disclose personal information. We have developed a privacy policy which explains what sort of personal information we hold about you and what we do with that information. For further queries regarding any of the above please our Privacy Officer or refer to our www.perrymans.com/privacy-policy. Important Instructions for Completing this Proposal Form All questions must be answered in full. Failure to do so may result in delays in providing a quotation or effecting the insurance. Where a Yes/No response is indicated please tick or cross the applicable box. This form must be signed by at least one principal, partner or director of the principal entity seeking insurance after all necessary enquiries have been made of the principals, partners, directors, employees and Consultants, Subcontractors & Agents of all entities seeking insurance. Where there is insufficient space to answer any question, or additional documentation or information is required, please provide same by way of a clearly labelled attachment to this proposal form and specify the applicable attachments in the space provided for each question. Provision of CV s and/or Company Capability Statement If you require any assistance in completing this proposal form please contact Perrymans. If a contract of insurance is agreed, this proposal form will form the basis of the contract 2 If there is insufficient space please attach via addendum
1. Your Details 1.1 Please provide the full legal name of all entities to be insured under the Policy: (It is important you include all service, administration or nominee companies) 1.2 Date established:.... 1.3 Your Contact details: Address:.. Telephone Number:... Email: 1.4 Principals Name Qualification Date Obtained Years as a Principal This Practice Previous Practice 1.5 Staff Details Principals / Partners / Directors Licensed / Registered Valuers Graduate / Student Valuers Sales Persons Property Managers Administrative Staff Other Staff Total Staff: 1.6 Are you a current financial member in good standing of the API? 3 If there is insufficient space please attach via addendum
2. General Business Questions 2.1 Has the name of your business ever changed? 2.2 Have you ever amalgamated or merged with another business? 2.3 Have you purchased any other business or practice? If you have answered Yes to any of these questions please provide details: 2.4 Does any Partner, Principal or Director of the Insured detailed in answer to Question 1.4 of this proposal have any connection or association (financially or otherwise) with any other business or practice? If Yes, please provide full details: 2.5 Does any single client represent more than 30% of your total activities? If Yes, who? 2.6 Do you engage sub-contractors? If Yes, i. Do you insist they carry their own Professional Indemnity Insurance? ii. What percentage of total revenue is paid to sub-contractors? % iii. Please specify the professional services subcontracted: 4 If there is insufficient space please attach via addendum
3. Valuation Work Break-Up 3.1 Property type Please provide a percentage split of income derived from: Now 6 years ago Residential under $2 Million % % Residential over $2 Million % % Industrial under $5 Million % % Industrial over $5 Million % % Commercial under $5 Million % % Commercial over $5 Million % % Rural properties * % % Retail outlets % % Hotels / pubs / licensed premises % % Shopping centres % % Sporting complexes % % Caravan parks % % Plant / machinery % % Business valuations % % Vacant land % % Other (please provide details below) % % Total: 100% 100% * Rural properties include vacant land, buildings on land and farming or income generation on land outside a City or town centre 3.2 Approach Please provide a percentage split of income derived from: Now 6 years ago Full valuations % % Kerbside / restricted access valuations % % Desktop assessments % % Total: 100% 100% 5 If there is insufficient space please attach via addendum
3.3 Purpose Now 6 years ago Mortgages % % Development valuations ( as if please complete below) % % Rent reviews % % Land tax / stamp duty valuations % % Insurance valuations % % Management rights % % Tax depreciation schedules % % Other (please provide details below) % % Total: 100% 100% 3.4 If you have conducted development valuations in the last six years, provide the following details: i. Were they as if valuations? ii. Were they unit developments? iii. Were all conducted and signed off by a valuer with at least 5 years development valuing experience or 10 years general valuing experience? iv. How many such valuations? v. What was the average valuation? vi. Who were the developers? 3.5 Recipient Please supply a breakdown of your valuations performed for the following: Now 6 years ago Authorised Deposit Taking institutions % % Non-bank securitised lenders % % Government institutions % % Buyers % % Other (please provide details below) % % Total: 100% 100% 6 If there is insufficient space please attach via addendum
3.6 In the last six years have you carried out any valuations for any of the following & other related entities? Banksia Mortgages Limited Bluestone Group Pty Limited Gippsreal Limited Investec Bank (Australia) Limited La Trobe Financial Services Pty Limited Pepper Australia Pty Ltd Permanent Custodians Limited Provident Capital Limited Resimac Limited Private and MIS lenders Property Investment funds If Yes, please provide details below: 3.7 Please provide details of your 5 largest single valuations undertaken in the past 3 years: Brief Description of Contract Income $AUS 3.8 Please advise the average value of all properties / assets valued in the past 3 years: $... 7 If there is insufficient space please attach via addendum
4. Risk Management 4.1 Do you have formal documented Risk Management protocol? If Yes, please: a) Provide a copy of this document. b) Advise when was the program implemented?. c) Is it subject to regular review? 4.2 Are the staff provided with ongoing training in respect of the content and application of these programs? 4.3 Does the Proposer use a standard form of contract or terms of engagement? If Yes: i. Does this contract or terms of engagement contain a clause providing disclaimers, and a limitation to your liabilities? ii. Does your standard contract include clauses relating to limitation of use of the valuation? 4.4 a) Do you have formal procedures to approve non-standard contracts? b) If you use non-standard contracts do you ensure they contain a clause providing disclaimers, limitations on use of the valuation and a limitation to your liability? 4.5 Does the Proposer have in place any formal procedures for the identification and reporting of incidents or circumstances which may give rise to a professional indemnity claim? 4.6 Does the Proposer have formal procedures in place to review their methods, processes and practices, with the intention of avoiding the future occurrence of any similar incidents or circumstances which may give rise to a professional indemnity claim? 4.7 Are valuations always confirmed in writing? 4.8 Are all valuations signed off by a Director or senior licensed valuer? 4.9 What is your Director to Valuer ratio? (Eg: 1:4).. 4.10 Does the proposer have in place formal peer review processes? If Yes, advise when they were first implemented:.. 4.11 Do you employ Graduate / Student valuers? If Yes, are student / graduate valuers always accompanied by a qualified and registered valuer on all valuations? 8 If there is insufficient space please attach via addendum
5. Financial Details 5.1 Please advise the total annual gross professional fees for: Australia Last financial year: $ $ Average last 3 years: $ $ Estimate for next 12 Months: $ $ 5.2 Stamp Duty Split: Overseas Please provide the approximate percentage of your activities (based on fee income) applicable to each State or Territory. NSW VIC QLD SA NT WA ACT TAS O/S Total 100% 5.3 If you perform work outside Australia, or work for clients located overseas please provide details of the countries involved: 6. Claims History 6.1 After enquiry, have any claims for negligence or breach of professional duty been made against your business or practice or any of its predecessors in business or any prior business or practice or any of its present or former Partners, Principals or Directors or has any fact or circumstance been notified to the insurers that has the potential to give rise to a claim? If Yes, please provide full details: Date Notified Name of Claimant Brief Description of Matter Quantum Status If Yes, have all such claims or circumstances been notified to past insurers? 9 If there is insufficient space please attach via addendum
6.2 After enquiry, are any of the Partners, Principals or Directors aware of any fact or circumstance which has the potential to give rise to a claim against your business or practice or any business or practice of any of their present or former Partners, Principals or Directors which is not referred to in 6.1 above? If Yes, please provide full details including: Date first became aware of matter Name of Potential Claimant Brief Description of Matter Quantum 6.3 Has any Partner, Principal, Director or staff member ever been subject to disciplinary proceedings for professional misconduct or ever had an application of insurance declined? If Yes, please provide details: 6.4 After enquiry, are any Partners, Principals, Directors or staff members aware of any enquiry, professional disciplinary proceedings or similar process connected to your business which they, or any other member, may be required to attend? If Yes, please provide details: 10 If there is insufficient space please attach via addendum
7. Cover Required 7.1 Limit of Indemnity Options: $1,000,000 $2,000,000 $2,500,000 $5,000,000 $10,000,000 Other 7.2 Preferred Deductible Options: $10,000 $20,000 Other $... 7.3 Do you require Fidelity Cover? If Yes; a. Do you always obtain satisfactory references before hiring employees? b. Do you require more than one member of staff to sign cheques, handle cash or transferable documents? c. Is the bank reconciliation conducted by someone not authorised to deposit into or withdraw from the bank accounts? 7.4 Do you require Partners Previous Business cover? If Yes, Names of Partners / Principals / Directors Name of Previous Practice Period Practising as a Partner / Principal / Director 11 If there is insufficient space please attach via addendum
8. Declaration I the undersigned declare that: 1. I have read and understood the IMPORTANT NOTICES RELATING TO THIS PROPOSAL at the start of this proposal form. 2. I confirm that I am authorised to act for and on behalf of all persons/parties who may be entitled to indemnity under any policy which may be issued pursuant to this proposal form and I acknowledge that I am completing the proposal on their behalf. 3. The statements and particulars in this Proposal (which includes any attachments and information supplied) are true and correct and that I have not misstated or supressed any facts that may be material. 4. I acknowledge that I have a continuing obligation to notify you of any material changes. Should any material facts alter between the date of this Proposal (which includes any attachments and information supplied) and entering into any contract of insurance to which this Proposal (which includes any attachments and information supplied) relates, I will advise you immediately. 5. I understand and agree that this Proposal (which includes any attachments and information supplied) will form the basis of any Contract of Insurance arranged. 6. I understand that the signing of this proposal form does not bind the proposer or insurer to complete this insurance. I/We hereby agree that this Declaration shall be the basis of the contract between me/us and Insurers. Signed on behalf of all Partners / Directors / Principals DATE: / / FOR & ON BEHALF OF: SIGNATURE: NAME: POSITION: 12 If there is insufficient space please attach via addendum