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Food Van Insurance by City Rural Insurance Broker

Mobile food vending may seem like a simple task but is fraught with unforeseen hazards; to the owner, their equipment, and the public.

Staging Form

Step 1 of 5 - Your Details

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Name of Insured/Business:(Required)
Name(Required)
First Last
Email:(Required)
Phone:
Address(Required)
Street Address City State Postcode Country

VEHICLE DETAILS
- Trailer
- Van
Year(Required)
Make(Required)
Model(Required)
Number of Axles(Required)
Rego No(Required)
Value of Vehicle $(Required)
For vehicles over 30 years, Please confirm when all the critical components such as brakes, wiring & Tyres have been updated
Is your vehicle built with EPS / Coolroom Panels(Required)
These panels are single piece factory engineered units typically comprised of two metal faces bonded to a fully insulating core.
- Yes
- No
Modifications / Fixed Equipment / Fit Out
Value of Fit Out $(Required)
TOTAL SUM INSURED $
Is the Trailer fitted with a Wheel Clamp or Tow Hook Lock?
- Yes
- No
Type(Required)
Where is the vehicle kept overnight
Postcode
Where is the vehicle parked at night?
- Garage
- Driveway
- Carport
- Street
Finance(Required)
- Yes
- No
Finance Company(Required)
Do you use any Deep Fry Appliances(Required)
- Yes
- No
If Yes(Required)
- Bench top
- Built In
If Yes, Please Confirm(Required)
- Number of Units
- Type: Gas
- Electric
- Number of Bays/Liters
Contents (Separate Policy Required)
Non Fixed Contents (Please Specify with Value)

DRIVERS
Drivers: Please supply Details of all drivers(Required)
Name Date of Birth
History
No Claim Bonus (Subject to Written Confirmation)
- Nil/6
- 20%5
- 30%4
- 40%3
- 50%2
- 60%1
In the last 5 years have you had
Accidents or Claims(Required)
- Yes
- No
Traffic Offences (excluding parking)(Required)
- Yes
- No
Licence Cancelled / Endorsed / Suspended(Required)
- Yes
- No
Insurance Refused / Declined / Cancelled(Required)
- Yes
- No
Criminal Convictions(Required)
- Yes
- No
If yes to any of the above please give full details(Required)

PUBLIC AND PRODUCTS LIABILITY
- Option A - $10,000,000 Public and Products Liability
- Option B - $20,000,000 Public and Products Liability
Number of Food Vans / Trailers used in connection with your business
Full Descriptions of Food sold
Estimated Gross Annual Sales $
Are any products IMPORTED or EXPORTED by you / your business?(Required)
- Yes
- No
If Yes, Please attach a detailed list of each product imported / exported and the country of origin / destination
Max. file size: 2 MB.
a) Are you or have you previously been insured against the risks to be insured?(Required)
- Yes
- No
b) Have you had any claims made against you (whether insured or not)?(Required)
- Yes
- No
c) Have you had any incident or accident occur which would have been covered by the proposed insurance policy?(Required)
- Yes
- No
d) Have you had any insurance declined or cancelled, proposal rejected, renewal refused, claim rejected, special Conditions or special excesses imposed by an insurer?(Required)
- Yes
- No
e) Have you ever been convicted of a criminal offence?(Required)
- Yes
- No
Please add photos of your food van(s) if possible
Drop files here or

Max. file size: 2 MB.
General Comments

Consent(Required)
Please note no cover applies for loss or damage caused by Mechanical Breakdown, Electrical Breakdown, or Electronic Breakdown under any Section of the Policy.
Name:(Required)
Signature(Required)
Date(Required)
DD slash MM slash YYYY
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

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CITY RURAL INSURANCE BROKERS PTY LTD

Australian Financial Services Licence No 237491
ABN: 52 074 444 296

Financial Services Guide

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Name	Date of Birth

Step 1 of 5 - Your Details

Contents (Separate Policy Required)

DRIVERS

History

In the last 5 years have you had

PUBLIC AND PRODUCTS LIABILITY