NEW BUILDING CHECKLIST NEW BUILDING CHECKLIST Council(Required)Albury City CouncilArmidale Regional CouncilBallina Shire CouncilBalranald Shire CouncilBathurst Regional CouncilBega Valley Shire CouncilBellingen Shire CouncilBerrigan Shire CouncilBland Shire CouncilBlayney Shire CouncilBogan Shire CouncilBourke Shire CouncilBrewarrina Shire CouncilBroken Hill City CouncilByron Shire CouncilCabonne CouncilCampbelltown City CouncilCanterbury Bankstown CouncilCarrathool Shire CouncilCastlereagh-Macquarie County CouncilCentral Coast CouncilCentral Darling Shire CouncilCentral Murray County CouncilCentral Tablelands CountyCessnock City CouncilCity of Canada Bay CouncilCity of RydeClarence Valley CouncilCobar Shire CouncilCobar Water BoardCoffs Harbour City CouncilCoolamon Shire CouncilCoonamble Shire CouncilCootamundra Gundagai Regional CouncilCowra Shire CouncilDubbo Regional CouncilDungog Shire CouncilEdwards River CouncilEurobodalla Shire CouncilFairfield City CouncilFederation CouncilForbes Shire CouncilGeorges River CouncilGilgandra ShireGlen Innes Severn CouncilGoldenfields Water County CouncilGoulburn Mulwaree CouncilGreater Hume Shire CouncilGriffith City CouncilGwydir Shire CouncilHawkesbury River County CouncilHay Shire CouncilHilltops CouncilHornsby Shire CouncilInner West CouncilInverell Shire CouncilJunee Shire CouncilKempsey Shire CouncilKu-ring-gai CouncilKyogle CouncilLachlan Shire CouncilLake Macquarie City CouncilLeeton Shire CouncilLismore City CouncilLithgow City CouncilLiverpool Plains Shire CouncilLockhart Shire CouncilMaitland City CouncilMid Coast CouncilMoree Plains Shire CouncilMosman Municipal CouncilMurray River CouncilMurrumbidgee CouncilMuswellbrook Shire CouncilNambucca Valley CouncilNarrabri Shire CouncilNarrandera Shire CouncilNarromine Shire CouncilNew England TablelandsNewcastle City CouncilNorfolk Island Regional CouncilNorth Sydney CouncilNorthern Beaches CouncilOberon CouncilPort Stephens CouncilQueanbeyan Palerang CouncilRandwick City CouncilRiverina Water County CouncilRous County CouncilShoalhaven City CouncilSingleton CouncilSnowy Valleys CouncilStrathfield CouncilSutherland Shire CouncilTamworth Regional CouncilTemora Shire CouncilTenterfield Shire CouncilThe Hills Shire CouncilTweed Shire CouncilUpper Hunter County CouncilUpper Hunter Shire CouncilUpper Lachlan Shire CouncilUpper Macquarie County CouncilUralla Shire CouncilWagga Wagga City CouncilWalcha CouncilWalgett Shire CouncilWarren Shire CouncilWarrumbungle Shire CouncilWaverley CouncilWeddin CouncilWentworth Shire CouncilWingecarribee Shire CouncilWollondilly Shire CouncilWoollahra Municipal CouncilYass Valley CouncilName(Required) First Last Position(Required)Email(Required) Phone(Required)BUILDING DETAILSCouncil Asset ID(Council Use Only)Asset Type(Required)Aquatic/Leisure CentreCar parkCaravan/Tourist ParkClinic/Childcare FacilityCommercial Premises (E.g. Airport, Restaurant, Shopping Centre)Community Centre/HallCouncil Chambers/Town HallEntertainment Centre/Museum/GalleryFire/Emergency ServicesLibraryOffice/Administration CentrePark/ReserveReservoir/Dam/Beach/RiverResidentialSporting FacilityStockyard/Pound/SaleyardTreatment Works/Waste Disposal DepotWarehouse/Storage FacilityWork Site/Roads/Footpath/Bridge/WharfWorks DepotOTHERPlease provide asset typePlease upload a current photograph of the building Drop files here or Select files Max. file size: 600 MB. Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Council's intended use of the buildingDoes the total declared replacement value (building and contents) exceed $10million?(Required)YesNoDeclared replacement value - Building(Required)Declared replacement value - Contents(Required)Please upload scale floor plans if available Drop files here or Select files Max. file size: 600 MB. Does this location generate annual gross profits in excess of $1 million?(Required)YesNoIf yes, please advise amount?Level of cover requested Indemnity Removal of Debris Only R & R Ownership Council Council Controlled Other If other, please advise.If tenanted, which best describes the occupier?Historical significanceYesNoCONSTRUCTION DETAILSTimber Walls Floors Roof Reinforced Concrete/Concrete Walls Floors Roof Fibrous Cement Walls Floors Roof Brick Walls Floors Roof Metal Deck Walls Floors Roof Galvanised Iron Walls Floors Roof Tile Walls Floors Roof Weatherboard Walls Floors Roof PVC Walls Floors Roof Please detail any other construction details not mentioned aboveSECURITY DETAILSPlease select the security options applicable to this building(Required) Burglar Alarm Smoke Detector Hydrant Fire Alarm Security Fencing Fire Hose Reel Extinguisher Exit Signs Sprinkler Emergency Lighting Other If other please specifyDESCRIPTION OF BUILDINGPlease provide a description of the buildingIs the building in a condition for immediate occupancy?YesNoAre the premises in good condition?YesNoIf no, please advise.Has the premises been impacted by recent weather events?YesNoIf yes, please advise.Does Council carry out any inspections?YesNoDo these inspections include an internal check of the building?YesNoAre all utility services still connected to the building?YesNoCollection StatementStatewide Mutual is managed by JLT Risk Solutions Pty Ltd (ABN 69 009 098 864 AFSL 226827) and is a business of Marsh and McLennan Companies (MMC). For details on how we use this information please refer to our Collection Statement which can be found here
