Expression of Interest.

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Business Information

Business Name *

Trading Name *

ABN *

ACN *

Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Business Phone *

Business Email *

Website *

Years in Operation *

Primary Contact Person

Name *

First

Last

Position/Title *

Contact Phone *

Contact Email *

Facility Information

Workshop Size (sq meters) *

Number of Work Bays *

Paint Booth Available *— Select Choice —YesNo

Vehicle Capacity (per month) *

Operating Hours *

Staff Information

Total Staff Count *

Qualified Technicians *

Apprentices *

Administrative Staff *

Services Offered

Services Offered *

• Panel Beating
• Spray Painting
• Mechanical Repairs
• Electrical Repairs
• Windscreen Replacement
• Detailing
• Towing Services
• Hire Vehicle
• NDAS Calibration

Vehicle Types Serviced

Vehicle Types Serviced *

• Passenger Vehicles
• Commercial Vehicles
• Luxury Vehicles
• Motorcycles
• Trucks
• Vintage/Classic

Public Insurance any

Certifications & Insurance

Public Liability Insurance Amount *

Product Liability Insurance Amount *

Workers Compensation Policy Number *

Business Insurance Policy Number *

Industry Certifications *

References

Current Insurance Company Relationships *

Trade References *

Business Relationships

Are you a preferred supplier for any Insurance companies/Hire car providers/Fleet companies? *— Select Choice —YesNo

If yes, please select: *

• Orix
• Custom Fleet
• IAG (NRMA, RACV, NZI, CGU, WFI)
• Suncorp (incl Vero, AA)
• Tower
• Avis Budget
• Europcar
• Sixt
• Hertz
• Yoogo Fleet
• THL
• Ezi Rentals
• Other

Please provide details of your other preferred supplier relationships *

Are you associated with or work directly with any demurrage or credit hire companies? *— Select Choice —YesNo

If yes, please select: *

• Right2drive
• Compass Claims
• Carbiz
• Notmyfault
• IMOK
• Other

Please provide details of your other demurrage/credit hire relationships *

Facility Capabilities

Is your facility equipped to complete both non-drive and drivable vehicles? *— Select Choice —Yes – Both drivable and non-drivableDrivable vehicles onlyNon-drivable vehicles only

Do you offer any services outside of Smash Repairs? *— Select Choice —YesNo

Please select all additional services you offer: *

• Towing
• Recalibration
• Roadworthy Inspection
• Vehicle Storage
• Vehicle Recovery
• Parts Supply
• Other

Please provide details of other additional services you offer: *

Capacity Planning

Weekly capacity for driveable vehicles (should you be successful) *

Weekly capacity for non-driveable vehicles (should you be successful) *

Additional notes about your capacity *

Additional Information

Specialisations *

Additional Comments *

By submitting this form, I confirm that all information provided is accurate and complete. *

• By submitting this form, I confirm that all information provided is accurate and complete.

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