Insurance Questionnaire

Contractor Name: «PRASUN» «ROY CHOWDHURY»

FOR ALL CONTRACTORS (PAYG/PTY LTD):

Have you ever been involved in a claim relating to the following insurances?

YES NO
Workers Compensation

Public Liability

Professional Indemnity

If YES to any of the above, please provide details below:

PTY LTD CONTRACTORS ONLY:

Can you confirm you hold current policies for the following;-

YES NO
Workers Compensation

Public Liability

Professional Indemnity

Or if you would like Talent to cover you for Public Liability and Professional Indemnity at a rate of 1.5% of gross
earnings, which will be deducted from your pay.
YES NO

We can only offer PL/PI insurances for single operator entities (i.e. only 1 working employee in the Pty Ltd
entity).

Note: It is condition of contracting with Talent International that current policies are in place for the duration
of this contract and subsequent extensions with Talent International. Please confirm your compliance with this
condition.
YES NO

Please provide copies of each with your starter information.

Signed: ____ ____ Date: ________04.09.2018________________