Broker Agency Agreement printable pdf download

Broker Agency Agreement

Global Transport & Automotive Insurance Solutions Pty Ltd

ACN 069 048 255 ABN 93 069 048 255

Australian Financial Services Licence No. 240714,

Level 6, 55 Chandos Street St Leonards NSW 2065

P.O. Box 507 St Leonards NSW 1590 DX 3315 St Leonards

Telephone (02) 9966 8820

Fax: (02) 9966 8840

Email: .au

Website:

BROKER AGENCY AGREEMENT

BETWEEN

Global Transport & Automotive Insurance Solutions Pty Ltd

(“GT Insurance”, “We”, “Us”, “Our”) ABN 93 069 048 255

of Level 6, 55 Chandos Street St Leonards NSW as agent for Allianz

Australia Insurance Ltd ABN 15 000 122 850 ( “Insurer”).

AND

Name: ………………………………………………………………………………...

(“Broker”, “You”, “Your”)

ABN: …………………………………………………………………………………

Australian Financial Services Licence No.: ………………………………………

Postal Address: ……………………………………………………………………..

Street Address: ………………………………………………………………………

Phone No. ……………………………… Fax No. ………………………………..

This Agreement is made on the ………………………..day of ………………………….. 20

AGREEMENT

Acceptance

1. All business will be transacted on an offer and acceptance basis, i.e. We are

under no obligation to agree to insure a proposed risk, regardless of whether a

quotation has been provided or interim cover has been granted in respect of that

risk.

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Broker Agency Agreement