stdClass Object ( [id] => 34 [menutype] => footermenu [name] => Directors and Officers [alias] => directors-and-offices [link] => index.php?option=com_aicontactsafe&view=message&layout=message&pf=11 [type] => component [published] => 1 [parent] => 0 [componentid] => 34 [sublevel] => 0 [ordering] => 11 [checked_out] => 63 [checked_out_time] => 2013-11-20 02:06:46 [pollid] => 0 [browserNav] => 0 [access] => 0 [utaccess] => 0 [params] => redirect_on_success= page_title=Directors and Officers show_page_title=1 pageclass_sfx= menu_image=-1 secure=0 [lft] => 0 [rgt] => 0 [home] => 0 [component] => com_aicontactsafe [tree] => Array ( [0] => 34 ) [route] => directors-and-offices [query] => Array ( [option] => com_aicontactsafe [view] => message [layout] => message [pf] => 11 ) )
Directors and Officers
Fields marked with * are required.
SECTION 1: DETAILS OF THE PROPOSER 
 
 
 
 
 
 
SECTION 2: PROFESSIONAL BUSINESS 
Currently Insured 
 
 
 
 
 
STAMP DUTY & TAXES SPLIT 
 
 
 
 
 
 
 
 
 
 
SECTION 3: GENERAL INFORMATION 
Upon enquiry, is any Director, Officer or Employee of the Company aware of any facts or circumstances that may affect the ability of the Company to meet its debts as and when they fall due or any change in the financial position or capital structure of the Company that may materially affect the performance of the Company? 
Upon enquiry, (a) has any claim(s) been made against any Director, Officer or Employee of the Company for any matter that is or would be the subject of this insurance policy in the past 5 years where the value of all claims notified exceed $20,000 including current reserves, or (b) is any Director, Officer or Employee of the Company aware of any circumstance or incident which may give rise to a claim under the policy? 
Upon enquiry, has the Company ever had any loss sustained through the fraud or dishonesty of any employee? 
Has your business, practice or any partner, principal or director ever been declined this type of insurance, or had similar insurance cancelled, or had an application for renewal declined, or had special terms or restrictions imposed? 
SECTION 4: INCOME DETAILS 
 
SECTION 5: DECLARATION 
I/WE on behalf of the INSURED declare that the statements and particulars in this Declaration are true and that no material facts have been misstated or suppressed after enquiry. I/WE on behalf of the INSURED agree that should any of the information given by us alter between the date of this Declaration and the inception date of the insurance to which this proposal relates, I/WE will give immediate notice thereof. The undersigned agrees that this Declaration, together with any other information supplied by us, shall form the basis of any contract of insurance effected thereon. 
 


 

If you would like to enquire about insurance, please complete our Enquiry Form and someone from our office will be in contact shortly.

Enquiry Form