Single Credit Risk Quote

For a whole turnover quote – please fill in a different form: Whole Turnover Quote Form
For a political risk quote – please fill in a different form: Political Risk Quote Form

Your Company Information


Exposure To Be Insured


Previous Experience of the Applicant Relevant to the Risk(s) To Be Insured



Type of Insurance Cover Sought



Declaration


The Applicant confirms that its statements in this Application are true and no material information has been withheld. The Applicant confirms that the existence of any policy issued will not be disclosed to the obligor(s) or any other third party other than our own professional advisors on a confidential basis or as required by law and except as may be permitted in accordance with the terms of any policy issued. The Applicant also confirms that it is aware that non-disclosure of any material information known to the insured may void the policy.
The Authorized Officer of the Applicant agrees that all information in this Application will be treated confidentially by the Applicant. Signing of this Application does not bind the Applicant to purchase the requested insurance. The Applicant hereby appoints Political And Credit Risks Ltd as our broker of record for the placement of any policy of which this Proposal Form forms the basis.