Insurance Application Form

IMPORTANT NOTICE TO THE APPLICANT

ArchiTeam MEMBERSHIP DETAILS
Membership runs from 31 May until 31 May each year.
Annual Membership $399.30 (incl. GST)
Joining Fee $71.50 (incl. GST)
ArchiTeam Share $1 (one off payment)
All Applicants must be a registered Architect or graduate in Architecture.
I agree to pay all charges required by the Cooperative and to be bound by the rules and regulations of the Cooperative and by any alterations thereof registered in accordance with the Act. These rules and regulations can be viewed online at https://www.architeam.net.au/about-architeam/the-architeam-rules

CLAIMS MADE POLICY
This policy is a claims made policy of insurance. This means that the policy covers you for claims made against you and notified to the Insurer during the period of insurance. The Policy does not provide cover 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 (whether made or issued by the Insurer or any other insurer);
claims made against you prior to commencement of the period of insurance;
claims arising out of claims and circumstances noted on the proposal form for the current period of insurance or on any previous proposal form;
subject to what is said in the next paragraph, claims made after expiry of the period of insurance even though the event giving rise to the claim may have occurred during the period of insurance.

However, where you give notice in writing to the Insurer of facts that might give rise to a claim against you as soon as reasonably practicable after you become aware of those facts but before expiry of the period of insurance, the policy will, subject to its terms and conditions, cover you notwithstanding that a claim is only made after expiry of the period of insurance.

YOUR DUTY OF DISCLOSURE
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 which 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 us before you renew, extend, vary or reinstate a contract of insurance.

Your duty however does not require disclosure of a matter:

that diminishes the risk to be undertaken by the insurer
that is common knowledge
that the insurer knows or, in the ordinary course of business as an insurer, 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 its liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, the insurer may also have the option of avoiding the contract from it’s beginning.

15 month member

Yes
No

Are you currently an ArchiTeam member*

Yes
No
Retiring / Non Practicing Member

As a process for the review of your membership application, ArchiTeam requires a CV. Please attach CV here, or email admin@architeam.net.au with your CV.

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 4 MB, Max. files: 3.

For run off cover please click on the link below to complete the PI run off form

CLICK HERE FOR PI RUN-OFF PROPOSAL FORM

Membership Number*

Are you Renewing or Applying for Insurance*

Renewing
Applying

1. Applicant Details (As appears on Certificate of Currency)

Are you a....*

Sole Trader
Company
Partnership

Full legal name of each current incorporated company, unincorporated business, trading name or entity to be insured:

Sole Trader Principals Name*

Company Name*

Partnership Business Name*

Commencement date of business*

ABN/ACN

Additional Company Details

Tick to add Company

Company Name*

Commencement date of business*

ABN/ACN

Additional Company Details

Tick to add Company

Company Name*

Commencement date of business*

ABN/ACN

Registered architect/s to appear on the Certificate of Currency

Business Name (If you want included on Certificate of currency

Registered ArchItect Name*

Additional Registered Architect Name

2. Main Contact Person Details

Contact Name (PLEASE ALSO INCLUDE IN SECTION 4 IF PARTNER/DIRECTOR)*

Phone*

Mobile*

Contact Email*

Website

Fax

Office Address*

Suburb*

State*

Postcode*

3. Staff

Number of principal(s)/partner(s)/director(s):*

Total Staff (Including principals, partners, directors)*

4. Details of Principal(s)/Partner(s)/Director(s)

Name of Principal/ Director/Partner*

Age*

Architect Registration Number*

Email*

Phone Number*

Name of Principal/ Director/Partner*

Age*

Architect Registration Number*

Email*

Phone Number*

Name of Principal/ Director/Partner*

Age*

Architect Registration Number*

Email*

Phone Number*

Name of Principal/ Director/Partner*

Age*

Architect Registration Number*

Email*

Phone Number*

Please Note: To be covered all Principal(s)/Partner(s)/Director(s) need to be current members of Architeam.

Architects Insurance Application Form.

Step 1 of 6

IMPORTANT NOTICE TO THE APPLICANT

For run off cover please click on the link below to complete the PI run off form

1. Applicant Details (As appears on Certificate of Currency)

2. Main Contact Person Details

3. Staff

4. Details of Principal(s)/Partner(s)/Director(s)

5. Business Relationships

6. Split of Professional Services

7. Split of Work Undertaken

8. Fees / Income Details

9. Overseas Activities

10. Risk Management

11. Claims History

12. Insurance History

13. Any Additional Information you Wish to Provide

14. DECLARATION

Donate to ArchiTeam Research

Before completing the submission please consider helping ArchiTeam improve your industry

Please be patient when clicking SUBMIT. It may take up to 10 seconds to process

Pricing For Testing