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ARGIS Farm Extra Quote Request |
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Step 01.
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Step 02.
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Step 03.
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| Brokerage/Authorised Representative Details |
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To receive a quote from ARGIS, please complete all required sections prior to submitting the quote request.
You are able to switch between pages of the form without losing data, however you will not be able to save incomplete forms.
At the end of the quote process a copy of the quote request form will be generated to the email you've entered.
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| Section 1 - Insured Details |
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| Number of Situations |
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| Property names only will not be accepted. We require the full street address, suburb/town and postcode for each Farming Situation. |
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| Farm Type |
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Additional Details of Occupation
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| Please Complete the Following Questions for All Sections |
| 1. Has the insured in the past five years: |
| a) Had any insurance declined or cancelled, proposal rejected, renewal refused, claim rejected, special conditions or excess imposed by an insurer? |
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If YES, please provide full details
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| b) Suffered any loss or damage whether You made an insurance claim or not, or had any claims made against You? |
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If YES, please provide full details (Insurer, DOL, type of loss or damage, vehicle and driver details if
applicable, amount paid)
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| 2 Has the insured: |
| a) Ever been declared bankrupt? |
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| b) Ever been involved in a company or business which has become insolvent or subject to any form of insolvency administration (e.g. liquidation or receivership)? |
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| c) Been convicted of any criminal offence within the past five years? |
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| d) Been liable for any civil offence or pecuniary penalty (exceeding $5,000)? |
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If YES, full details (e.g., name of insurer, dates)
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Notes
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NOTICE
This document is a request for a Quotation for insurance only. SGUAS Pty Ltd trading as
ARGIS Insurance ('ARGIS') (ABN 15 096 726 895, AFSL 234437) reserves the right to decline any request for
Quotation for insurance and to verify any provideation provided.
If cover is requested the insured is required to provide a signed Supplementary Declaration
within 30 days of the inception date of their cover note.
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If the quote request form is completed no proposal form will be required in the event that your quote is successful,
just a simple signed declaration form. Download the form below:
ARGIS Farm Extra Insurance Supplementary Declaration
Please read the following Privacy Information
The insurance product referred to on this website can only be purchased through a broker.
SGUAS Pty Ltd t/as ARGIS Insurance (ABN 15 096 726 895, AFSL 234437) (‘ARGIS’) acts under a binding authority as agent for the insurer of the product,
Pacific International Insurance Pty Limited (ABN 83 169 311 193, AFSL 523921) (‘Pacific’).
Any information provided on this website is general advice only and has been prepared without taking into account your client’s objectives, financial situation or needs.
Your client should consider these, having regard to the appropriateness of this advice, and the relevant Product Disclosure Statement (PDS), Target Market Determination (TMD) and
Financial Services Guide (FSG), available by calling us on 1300 794 364 or downloading it from the ARGIS website, before deciding to acquire, or to continue to hold, this product.
Steadfast Group Limited (ABN 98 073 659 677) (‘SGL’) has a shareholding in our agency. Some of the brokers we deal with may be SGL subsidiaries or associates.
We have access to shared services from SGL. These include (but are not exclusive to): model operating procedures, manuals, legal, technical, HR, compliance,
sum insured and product comparison tools; insurance cover placement and claims support; group insurance arrangements; and group purchasing arrangements.
These services are funded by SGL, subsidised by SGL or SGL receives a fee for them.
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