This is a proposal form for a policy relating to claims made against the Insured during the period of the policy online - CLAIMS MADE.
Please answer all the questions giving full and complete answers. Please use a separate sheet of paper if insufficient space. If necessary please write additional relevant facts on a separate sheet of paper.
The proposal form must be completed and signed & dated by a person who is of legal capacity and have the authorisation to request this insurance for the Proposer.
This form does not bind the Proposer but will form part of the Insurance contract if taken up.
All material facts must be disclosed, as failure to do so may render any policy or cerfiticate voidable, or severely prejudice your rights in the event of any claim. A material fact is one likely to influence acceptance or assessment of the proposal by Underwriters. If you are in doubt as to what constitutes a material fact, you should consult your broker.
Please supply the following additional information:
CV's of Principals
Copy of Standard Contract Terms and Conditions (if applicable)