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Management Liability Plus

    Please read this important notice before completing this proposal form.

    Management Liability Application

    The information you provide will allow us to arrange a series of quotations options for you to review.

    Step 1 of 5

    20%
    • Name of Company
    • In the questions below a reference to a "Company" means the policy Holder and all of its Subsidiaries. Subsidiary means any entity recognised by law to be a Subsidiary or in which the Company holds more than 50% of issued capital or more than one half of voting rights at a general meeting of the Company
    • Financial Information

    • Percentage of Income Generated By State:
    • Insurance History

    • Please advise
    • Fidelity - Fraud prevention Controls

    • Tick all that are relevant
    • Employment Practices Liability - Human Resources Management

    • Full Time Personnel
    • Please tick all that apply
    • Declaration

      I, the applicant declare that;
      i) I am authorised by each of the Insured to sign this Proposal Form; and
      ii) the above statements are correct, true and complete; and
      (iii) no information material to this proposal form has been withheld; and
      (iv) I understand that no insurance is in force until the insurer has confirmed acceptance
    • This field is for validation purposes and should be left unchanged.
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