TZY CO — Proposal Assistant

1. Company Details

We've pre-filled what we know — please verify and complete the rest.

Company Name

UEN

Year Established

Authorised Signatory

Signatory Email

Registered Address * Full address of the Proposer including all premises owned or occupied.

Please verify, and add any additional premises below in Section 2.

Description of your business * State the exact nature of the Business / Trade / Profession to be insured.

Products / services supplied * Details of all goods sold, supplied, repaired, serviced, or services rendered.

Indemnity / coverage limit required * Limit of Indemnity required for any one accident and in the aggregate.

Select all limits you'd like quoted. Not sure? Your Risk Architect will advise the most suitable limit for your business.

2. Premises

Tell us about where you operate.

Premises address(es) * Address of all premises owned, leased or occupied in connection with the Business.

Do you own or lease the premises? * State whether premises are owned or rented by the Proposer.

Floor area * Total floor area of the premises occupied.

Are the premises in good condition and well maintained? * Are the premises in a good state of repair and maintenance?

Yes No

Fire safety measures in place * State all fire protection and detection appliances installed at the premises.

3. Operations

Help us understand the nature of your work and risk exposure.

Do you carry out manual work away from your own premises? * Does the Proposer undertake work at locations other than the insured premises?

Yes No

Nature of work & estimated wages for off-site work

Nature of work	Estimated annual wages (S$)

Do you carry out any heat, welding or cutting work? * Is any work involving the application of heat (welding, soldering, grinding, cutting) carried out?

Yes No

Do you work at heights above 10m or below ground level? * Does any work involve heights exceeding 10 metres or work below ground / underground?

Yes No

Do you engage subcontractors? * Are any labour-only or bona-fide subcontractors engaged by the Proposer?

Yes No

Do you store, use or handle hazardous substances? * Are any explosive, flammable, toxic or otherwise hazardous materials used or stored?

Yes No

Do you carry out any work overseas? * Does the Proposer undertake any operations or contracts outside Singapore?

Yes No

4. Financials & Payroll

Estimates are fine — your Risk Architect will refine these with you.

Employees by role * State the number of persons employed and the total estimated annual wages, salaries and earnings.

Role type	Est. number	Est. annual wages (S$)

Turnover * State the estimated gross annual turnover / fees for the period of insurance.

Past 12 months turnover (S$)

Expected turnover — coming year (S$)

5. Insurance & Claims History

This helps your Risk Architect structure the right coverage and pricing.

Are you currently insured for General / Public Liability? * Is the risk currently insured? If so, state the name of the present insurer.

Yes No

Have you had any liability claims in the last 5 years? * Has any claim been made against the Proposer in the past five years, whether insured or not?

Yes No

Please give details of each claim

Claim #	Date	Nature of Claim	Amount (S$)	Status

Are you aware of any incidents that may give rise to a claim? * Is the Proposer aware, after enquiry, of any circumstance which may give rise to a claim?

Yes No

Has any insurer ever declined, cancelled or imposed special terms? * Has any insurer ever declined, cancelled, refused to renew, or required special terms or increased premium?

Yes No

6. Declaration & Sign Off

Please review carefully before signing.

I/We declare that the above statements and particulars are true and complete and that I/We have not withheld any material information. I/We agree that this proposal and declaration shall form the basis of the contract between me/us and the Insurer. I/We undertake to inform the Insurer of any material change occurring before the completion of the contract. Signing this proposal does not bind the Insurer to accept the risk, nor the Proposer to effect the insurance.

Full name of signatory *

Signature * Signature of Proposer or duly authorised official.

Draw your signature above using your mouse or finger.

I confirm I have reviewed every section above, that the information provided is true and complete to the best of my knowledge, and I agree to the declaration.

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New Proposal — General Liability

Submission Tracker

Public / General Liability Proposal

1. Company Details

2. Premises

3. Operations

4. Financials & Payroll

5. Insurance & Claims History

6. Declaration & Sign Off

You're all done!