Sub-Contractor Required Information Form

Business and Contact Details

ACN - Australian Company Number *

Director/Business Owner Name *

Registered Business Address *

Business Physical Address *

Accounts Contact Person Name *

Accounts Contact Phone Number *

Accounts Email Address *

Allocations Contact Name/s *

Allocations Contact Number *

Allocations Email Address *

INSURANCE DETAILS

Motor Vehicle Insurance

Motor Vehicle Insurance *

Yes

N/A

(Expiry) Motor Vehicle Insurance *

(Policy Number) Motor Vehicle Insurance *

(File) Motor Vehicle Insurance *

*Certificate of Currency only accepted, please do not upload your renewal notice

Cargo/Goods in Transit Insurance

Marine/Goods in Transit *

Yes

N/A

(Expiry) Cargo/Goods in Transit Insurance *

(Policy Number) Cargo/Goods in Transit Insurance *

(File) Marine/Goods in Transit *

*Certificate of Currency only accepted, please do not upload your renewal notice

Public Liability

Public Liability *

Yes

(Expiry) Public Liability *

(Policy Number) Public Liability *

(Sum Insured) Public Liability *

(File) Public Liability *

*Certificate of Currency only accepted, please do not upload your renewal notice

Workers Compensation (NSW, WA, NT, ACT) / WorkCover (QLD, VIC, SA) – sole traders excluded only

Workers Comp/WorkCover *

Yes

N/A

(Expiry) Workers Compensation (NSW, WA, NT, ACT) / WorkCover (QLD, VIC, SA) – sole traders excluded only *

(Policy Number) Workers Compensation (NSW, WA, NT, ACT) / WorkCover (QLD, VIC, SA) – sole traders excluded only *

(File) Workers Comp/WorkCover *

*Certificate of Currency only accepted, please do not upload your renewal notice

Income Protection Insurance - sole traders only

Personal Income Protection (Sole Traders only)

Yes

(Expiry) Income Protection Insurance - sole traders only *

(Policy Number) Income Protection Insurance - sole traders only *

(Sum Insured) Income Protection Insurance - sole traders only *

(File) Personal Income Protection (Sole Traders only) *

*Certificate of Currency only accepted, please do not upload your renewal notice

Permit/s held – if applicable

Do you hold an Oversize Over Mass Permit and is this carried in the vehicle? *

Do you carry the relevant NSW Class 1 Load Carrying Operators Guide or other relevant Gazette required under the HVNL? *

Do you engage other sub-contractor company/s to move loads allocated by Plant Haul to your company? If yes, a Sub-Contractor CoR Assessment form will be sent for you to complete. *