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To apply to participate in the ACI Catastrophe Reconstruction Program please complete the application form below. Unfortunately not all applications can be accepted as there are limited opportunities in each postcode.

On receipt of the completed application, your application will be reviewed for suitability, particularly relating to the need for additional providers in your area. You will be informed within 30 days of the status of your application.

Please note that all fields in this form are required. Any incomplete applications received will not be considered for participation.

Company Name: ABN:
 
CONTACT DETAILS
 
Street Address: Phone:
Suburb / City: Fax:
State: Mobile:
Postcode: Website:
    Email:
 
Postal Address: tick, if same as street address.
Suburb / City:
State:
Postcode:
 
 
COMPANY INFORMATION
 
GST:
Are you entitled / registered to claim ITC entitlements?
Builders Licence No: Expiry Date:
Name of Director 1: Director 2:
   
Have you or any of your directors been:
Convicted of a criminal offence? Bankrupt?
   
Years in Operation:
No. of Employees:
Hours of Operation:
Job Capacity:
 
Areas of Expertise / Trades Covered:


Builder OR Tradesman
 
Experience with Insurance Claims Reconstruction Work::
 
 
SCOPE OF PREFERRED WORK
 
DAMAGE
INDUSTRIAL
COMMERCIAL
DOMESTIC
MINOR
MEDIUM
MAJOR
 
LEGEND:
MINOR = Damage less than $12k in value
MEDIUM = Damage between $12k - $50k in value
MAJOR = Damage greater than $50k in value
 
 
REFEREES
 
 
NAME
COMPANY
PHONE NUMBER
1
2
3
 
 
DETAILS OF YOUR:
 
Accountant
NAME
COMPANY
PHONE NUMBER
       
Solicitor
NAME
COMPANY
PHONE NUMBER
 
 
RATES
 
Labour: ($) Travel(per/km): ($)
Incidentals: ($):    
Material: At cost or Other (please specify):
 
 
SYSTEMS
 
Is your company web enabled?
You must be web enabled to participate.
 
 
GEOGRAPHIC AREA COVERED
 
As there are only limited opportunities within each postcode not all applicants will be successful.

The applicants that are successful willbe required to pay an annual subscription fee to Australian Catastrophe Insurance.

Click here to see the cost of participation. (Link opens in a new window)
 
Please complete each section below.
 
GREEN | 1st Call for this Postcode

Select the postcode from which your company operates.
( ie. Your business is located here.)
   
 
 
   
     
 
YELLOW | 2nd Call for other postcodes when local capacity exceeded

Select the postcodes in which your company covers in the normal course of business then press the "Add Postcode" button.
( Control + Click to select multiple )


Your Selections
 
OR
  
  NIL (Outside green postcode)
STATEWIDE
AUSTRALIA-WIDE		  
 
ORANGE | Prepared to assist in the event of a natural disaster

Select the postcodes in which your company is prepared to assist.
( Control + Click to select multiple )


Your Selections
 
OR
  
  NIL (Outside green postcode)
STATEWIDE
AUSTRALIA-WIDE		  
 
 
ADDITIONAL INFORMATION
 
Please state why you believe that your company should be selected to participate.
 
 
CONFIRMATION
 
Please tick this box and read below.

By submitting this application I confirm having read the SLA and cost to participate pages. In the event of my application being successful I agree to the terms and conditions of the same.