SSPM Appointment Form This form is to be used by builders who currently use Bovill Risk & Insurance Consultants (BRIC) as their distributor for Home Building Compensation Fund Insurance (HBCFI) in NSW. Please fill out this form in one of the following ways: 1. Electronically on your computer using the Adobe Acrobat Reader software. 2. Print the form and complete by hand After completing the form, please send the form by email to hbcf@bric.com.au (completed electronically or scanned) or by mail to PO BOX 1020, Richmond North, VIC, 3121 (printed). Information about SSPM You can now access your own "Self-Service Portal ".To do this you will need to appoint a manager of the portal (SSPM) who will then be able to appoint additional users as required. All users will be able to view your turnover limits and job capacity. Please complete the fields below providing information about your preffered SSPM. (For more information about SSPM and who to appoint, please contact BRIC using the contact information at the bottom of the page.) SSPM First Name SSPM Last Name SSPM Mobile Number SSPM email address Declaration - to be signed by the Licensed Contractor By signing this document you'll make the above nominated person your SSPM for Home Building Compensation Fund Insurance (HBCFI) in NSW. The nominated person can access privileged information about your business. First Name Last Name Position Signature Field Date (DD/MM/YYYY) (If you fill out the document electronically you can sign the document by uploading a file with a photo of your signature. You can also print the completed form, sign the form by hand, and scan the document.) Office Location: Suite 14 71 Victoria Crescent Abbotsford Victoria 3067 Postal Address: PO BOX 1020 Richmond North Victoria 3121 Telephone: Facsimile: Toll-free: Email: Web: (03) 8862 2333 (03) 9419 2971 1800 077 933 (Interstate Calls only) hbcf@bric.com.au www.bric.com.au