Disclosure

Building Contractor Information

Please fill in all required fields marked with *

Contractor Details

Full Legal Name: _____________________
Type of Business*: □ Individual □ Partnership □ Limited Liability Company
Date Formed (if applicable): _____________________
Postal Address: _____________________
Telephone: _____________________
Email: _____________________

Key Contact Person

Person who will manage/supervise the building work and be available for client discussions
Name: _____________________
Telephone: _____________________
Mobile: _____________________
Role (e.g., Project Manager): _____________________
Qualifications & Experience: _____________________
Licensed Building Practitioner #: _____________________
MCM Registration #†: _____________________
Manufacturing Site Address†: _____________________
Note: Client must be notified of any changes to key contact person
† Only for contracts including modular component manufacture

Insurance Details

List all insurance policies related to the building work
Policy 1
Type: _____________________
Cover Amount: _____________________
Exclusions: _____________________

Guarantees & Warranties

Warranty/Guarantee 1
Type: _____________________
Product (if applicable): _____________________
Coverage Period: _____________________
Limits/Exclusions: _____________________