Management Liability Questionnaire

BIB Client Code*

Name*

First Last

Insured Name*

include whole entity name

Year Business began Trading?*

Email*

Phone*

Website

Risk Questions

Are you currently insuraced for ML?*

Company Industry

State Head Office is Located in?*

Number of staff (including directors) Estimated wages?*

Estimated Cross Turnover?*

Are you Domiciled in Australia?*

Are you exempt from any Stamp Duty or Insurance Premium?*

If yes, which state

How much do your turnover generate in each State/Territory*

Overseas	WA	VIC	TAS	SA	QLD	NT	NSW	ACT

must equal 100%

Do you have firewalls protecting your own and customer/client data?*

Are all mission/business critical systems and data information assets backed up and stored at another location?*

Do you protect all Personally Identifiable Information through Encryption?*

Do you have a data Protection/Privacy policy?*

Do you outsource the handling of any personally Indentifiable Information?*

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Phone

This field is for validation purposes and should be left unchanged.