SafeNet Insurance Contact Us Full Name Business Name ABN Email Address Phone Number State New South Wales (NSW) Victoria (VIC) Queensland (QLD) Western Australia (WA) South Australia (SA) Tasmania (TAS) Australian Capital Territory (ACT) Northern Territory (NT) Preferred Contact Method (Phone / Email) Phone Email Type of Insurance Required Public Liability Professional Indemnity Business Package Commercial Property Product Liability Workers Compensation Fleet Insurance Commercial Motor / Truck Insurance Landlord Insurance Event Insurance Home & Contents Cyber Insurance Management Liability Tool Insurance Travel Insurance Other Description of Business Years in Operation Annual Turnover Under $100,000 $100,000 – $250,000 $250,000 – $500,000 $500,000 – $1 Million $1M – $5M $5M – $10M Over $10M Number of Employees 0 (Sole Trader) 1–5 6–10 11–20 21–50 51–100 100+ Property Address Building Sum Insured Contents Sum Insured Number of Vehicles Vehicle Type Car Ute Van Light Truck Heavy Truck Trailer Plant & Equipment Other Required Coverage Limit Current Insurer Policy Expiry Date Desired Start Date Any Claims in Last 5 Years? Yes No Claims Details Any Policy Declined or Cancelled? Yes No Information is true and correct Agree to Privacy Policy Checkbox SafeNet Insurance is an independent third party business. RG Partners and Associates acts only as a referral partner and does not provide or control any insurance services. Any engagement is directly between you and SafeNet Insurance. Submit
