This is a proposal form for a policy relating to claims made against the Insured during the period of the policy only – 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 Directors & Officers Liability insurance for the Proposer.
This form does not bind the Proposer but will form part of the Insurance contract if taken up.
Please supply the following information: The last Annual Report & Accounts for the company The last Interim Report (if applicable)