Exclusively Cleaning Proposal (Page 8 of 9) in pdf

Exclusively Cleaning Proposal Page 8

Declaration

1 I/We declare that to the best of my/our knowledge and belief all statements and particulars given by me/us are

true and complete and that no material information or fact has been withheld or suppressed.

2 I am/We are authorised to sign on behalf of all proposers.

3 I/We agree

– that this proposal will be the basis of the contract between me/us and Ageas Insurance Limited

– that if any answers have been written by another person then for that purpose such person will be regarded as

my/our agent and not the agent of Ageas Insurance Limited

– to be bound by the terms and conditions of the policy.

4 I/We understand that

– the liability of Ageas Insurance Limited does not commence until this proposal has been accepted by them

– Ageas Insurance Limited reserve the right to decline any proposal.

5 I/We agree to the seeking of information from credit and other agencies in connection with this proposal.

Proposer’s signature

Status of signatory

Date

Please return your completed proposal form with copies of any additional documents required, to your agent.

Ageas Insurance Limited

Registered office address

Ageas House, Hampshire Corporate Park,

Templars Way, Eastleigh, Hampshire SO53 3YA

Registered in England and Wales No. 354568

Ageas Insurance Limited is authorised by the Prudential Regulation Authority and

regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

COM237 Nov 2014

Exclusively Cleaning Proposal Page 8