AZ-Tech Recruitment & Contracting - Business Details Form

Name (Family name first)
Business Name
Address of Registered Office
Company Structure
ABN
Insurances Certificate of Currency may be required by our Clients as evidence of your cover.
Superannuation	Independent Entities are ineligible for the Statutory Employer Contributions that PAYG contractors are entitled to receive. Company: Policy Number:
Public Liability	Company: Policy Number: Amount Insured: $ Expiry Date:
Professional Indemnity	Company: Policy Number: Amount Insured: $ Expiry Date:
Workers Compensation	Company: Policy Number:
CONFIDENTIALITY DISCLAIMER & AZ-TECH PRIVACY POLICY By submitting this form, you are declaring that the information contained is true and correct at the time of submission, and that you grant AZ-Tech Recruitment & Contracting Pty Ltd permission to retain and use the information provided for the purposes of obtaining projects or employment in accordance with my instructions to the Agency and under the principles enshrined in the Privacy Amendment Act 2000. I understand that I retain the right to access, change or remove my personal identifying information held by the Agency at any time in accordance with the provisions of the Act. AZ-Tech Recruitment & Contracting Pty Ltd has instituted a privacy policy in line with the Privacy Amendment Act 2000. You can find our policy here. If you have concerns or questions, please contact our Privacy Officer - Jan Day on (07) 3847 3988 or via e-mail at: janday@az-tech.com.au

AZ-Tech Recruitment & Contracting Pty Ltd
PO Box 244
COORPAROO QLD 4151
Phone: 07 3847 3988
Fax: 07 3847 3911
E-Mail: consultant@az-tech.com.au