BUSINESS INFORMATION FOR PRE-ELIGIBILITY (PLUMBER)

1. a) Register Business Name
    b) Business Type
2. Trading Name (if applicable)

* A copy of the Certificate of Business Registration for the Trading Name must be provided
3. Date Business Commenced
4. ABN Number    
5. Contractors Licence Number(s)  
IMPORTANT: The name on your ABN Certificate, your Master Plumbers membership, your company name and the name on your Licence(s) must be in the same name
6. Name of Primary Contact
   Postal Address
   Phone (home)
   Phone(mobile)
   Fax
   Email
7. Are you a Current Financial Member of the Master Plumbers Association?
   If "Yes", Membership Number       
8. Has any director, proprietor, principal, trustee, major shareholder or manager of your business:
a) Ever been involved with a business placed into external administration,
a scheme of arrangement, liquidation, provisional liquidation or receivership?
 
b) Ever been declared bankrupt, entered into a deed of assignment,
composition, scheme of arrangement with creditors, or been subject to
a legal judgement or currently have legal proceedings pending?
 
c) Anything you should tell us that could affect your financial position, capital structure or operations of your business of a material nature in the next 12-months?
 
d) Ever had a contractor's licence/registration refused, cancelled or
suspended in any state or territory in Australia?
 
e) Ever been refused Home Warranty Insurance?
 
f) Ever had a claim made against them or is aware of any circumstance
that may give rise to a claim against them for Home Warranty Insurance?
 
g) Ever had a penalty imposed on the by a court or Tribunal in relation
to residential home building?
 
h) Or any related parties or businesses, given any form of security to another
Home Warranty Insurer (eg. Deed of Indemnity/Assurance,
Bank Guarantee, Personal Guarantee or similar document?
 
i) Have you had any Public Liability Clames in the past 5 yearsr?
 
j) Do you currently hold a Letter of Eligibility for
Home Warranty Insurance with any other insurer?
 
9. Expiry date of your Public Liability Insurance
10. Total Number of:
   a) Working Proprietors
   b) Employees
   c) Subcontractors (average engaged at any one time)

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