MARCH FORM TEST - Architeam

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.

5. Business Relationships

Does the applicant engage in the manufacture, construction, erection or installation, or act as principal in connection with any contract involving manufacture, construction, erection or installation?*

Yes
No

Please note; there is no cover for any claims that may arise from this business, and there is no cover for any services provided for and on behalf of this business. Please contact Architeam if you require insurance for this business activity.

Please provide details*

Limit 500 characters

6. Split of Professional Services

Please advise the approximate percentage breakdown of the applicant’s professional services: (MUST EQUAL 100%)
NOTE: Contract Administration is not project management.

Architectural Design

Interior Design

Landscape Architecture

Town Planning/Urban Design

Heritage Architecture/Consulting

Architectural/CAD Drafting

Contract Administration

Fitout Design

Project Management

Other (please specify)

TOTAL (Must equal 100%)*

Project Management is where you directly engage and are responsible for the work of other sub consultants.
Please use the ‘Contract Administration’ box when you are referring to activities like monitoring the builders work and progress and liaising between the client and the builder

Please specify the other Professional Services provided*

7. Split of Work Undertaken

Please advise the approximate percentage breakdown of work undertaken into the following categories:

Individual Dwellings

Low Rise Residential Buildings (up to 3 floors)

High Rise Residential Buildings (above 3 floors)

Low Rise Commercial Buildings (up to 3 floors) last

High Rise Commercial Buildings (above 3 floors)

Small Industrial Building Projects (up to $5m in total construction value)

Large Industrial Building Projects (above $5m in total construction value)

Institutional Buildings

Other (please specify)

TOTAL (Must equal 100%)*

Please specify the other Work Undertaken*

Are you aware of being involved in/working on any projects where Aluminium Composite Panelling (ACP) was installed?

Yes
No

Name and Address of Project

Your Role

Total Contract Value ($)

Cost of Cladding Component ($)

Additional details..

Tick to add additional ACP project

Name and Address of Project

Your Role

Total Contract Value ($)

Cost of Cladding Component ($)

Additional details..

Tick to add additional ACP project

Name and Address of Project

Your Role

Total Contract Value ($)

Cost of Cladding Component ($)

For any additional projects with ACP please complete using seperate document and attach pdf here.

Drop files here or

Max. file size: 256 MB.

8. Fees / Income Details

Please provide the full amount of gross incomes/fees earned by the applicant: (in Australian $) ie $40,000

Last 12 Months AUSTRALIA ($)*

Last 12 Months OVERSEAS ($)*

Next 12 Months AUSTRALIA (Estimate) ($)*

Next 12 Months OVERSEAS (Estimate) ($)*

This is your disclosed income for next 12 months. If this is not correct please adjust above

Please provide a percentage breakdown of the fee income disclosed in question 9 (a) by state and/or territory

New South Wales

Victoria

Queensland

South Australia

Western Australia

Tasmania

Northern Territory

ACT

Overseas

TOTAL (Must equal 100%)*

Is your private practice your full-time employment?*

Yes
No

9. Overseas Activities

The ArchiTeam Master Policy will automatically cover all work done in AUSTRALIA and NEW ZEALAND. It does NOT automatically cover paid architectural work for overseas projects. If you do require cover for paid work on overseas projects click yes to the question below and we can source you a quote with a loading to include this cover.

Have you or are you likely to undertake work overseas for which you require to be insured under this policy?*

Yes
No

Details of professional services provided*

Country*

Fee income ($Aud)*

Details of professional services provided

Country

Fee income ($Aud)

Details of professional services provided

Country

Fee income ($Aud)

10. Risk Management

Does the applicant use a standard agreement or form of contract outlining your terms of engagement?*

Note: ArchiTeam can provide a legally reviewed and formatted Client Architect Agreement, alternatively you must have your own agreement or contract legally reviewed at your own cost.

Yes
No

When acting as the lead architect (under this business name) please state the value of the largest project undertaken in the last five years ($)*

11. Claims History

Has any Principal or staff member ever been subject to disciplinary proceedings for professional misconduct?*

Yes
No

Please provide details:*

During the past 10 years has any Claim been made, or has negligence been alleged, against any entity or individual to be insured by this insurance (including any prior corporate entity and any of the present or former Principals), or have any circumstances which may give rise to a claim against any of these been notified to insurers?*

Yes
No

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

Additional details..

Tick to add additional details

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

Additional details..

Tick to add additional details

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

Are there any circumstances not already notified to insurers which may give rise to a Claim against any entity or individual to be insured by this insurance (including any prior corporate entity and any of the present or former Principals).*

Yes
No

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

Additional details..

Tick to add additional details

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

Additional details..

Tick to add additional details

Name of Claimant or Potential Claimant*

Name of Insurer*

Date*

Description of Problem*

Amount Paid or Outstanding ($)*

Finalised or Outstanding*

12. Insurance History

Has the applicant or any proposed person or entity ever had a professional indemnity insurer:

Decline a proposal?*

Yes
No

Impose special or unusual terms?*

Yes
No

Declined to continue your insurance/offer renewal terms?*

Yes
No

Cancel a professional indemnity insurance policy?*

Yes
No

Please provide details:*

13. Any Additional Information you Wish to Provide

Is there any additional information you wish to provide*

Yes
No

Use as much space as required)*

14. DECLARATION

I/We declare and acknowledge that:

I/we have made due inquiry of our principals, partners, directors and employees concerning the questions asked within this proposal and have authority to sign this proposal on their behalf;
I/we have read and understood the Important Information of this proposal;
the statements and particulars in this proposal are true and correct;
this proposal along with any other information supplied by me/us shall form the basis of any policy entered into;
I/we understand that up until the policy is entered into, we must notify any change in the matters disclosed in this proposal; and
I/we will notify any material alteration to the matters disclosed in this proposal occurring after completion of the proposal.
If you agree to these terms and conditions, you are also agreeing to the ArchiTeam Terms and Conditions

You must agree to the form to proceed*

Agreeing to the form does not bind the practice or Insurers to complete the insurance.

I AGREE

Donate to ArchiTeam Research

Before completing the submission please consider helping ArchiTeam improve your industry

The ArchiTeam Cooperative Mission is, in part, to utilise our combined voices, to support members in their work and professional learning and raise the profile of the industry.
To do this ArchiTeam needs to fund research that provides the industry with evidence of the importance of using small, medium and emerging architects and architecture practices. Research for Architects in Small Practice (RAsP) is one such research initiative that is already underway.

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Donation total

Next 12 Months Total

Last 12 Months Total

Additional member fee Partners 2

Additional member fee Partners 3

Additional member fee Partners 4

Additional member fee Partners 5

Paid 15 month 1 x member

Paid 15 month 2 x member

Paid 15 month 3 x member

Membership Total

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Earn ABOVE 1.9M

Insurance Price

Total Due Member

Joining Fee New Partner 1

Joining Fee New Partner 2

Joining Fee New Partner 3

Joining Fee New Partner 4

Total Joining Fee New Member/s

Share Fee New Partner 1

Share Fee New Partner 2

Share Fee New Partner 3

Share Fee New Partner 4

Total Share Fee $1 New Member/s

Total Due New Member/s

Total Due Member ARTSPAY

Total Due New Member/s ARTSPAY

Existing Member

New Member

Total Above 3 stories

Phone

This field is for validation purposes and should be left unchanged.

2023 FORM TEST

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

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