I, the undersigned, certify that I have no knowledge of any claims, legal, or otherwise, which have been or may be made, against any entity or individual for which insurance is requested, which has not been reported previously to you or another insurance company. In addition, after making reasonable inquiries, I am not aware of any act, error or omission, or allegations of any act, error or omissions, or any other circumstances or incidents which could give rise to a claim as a result of the Company’s operations or any individual’s activities on behalf of the Company.
I understand that the insurance Company’s willingness to provide coverage or reinstate coverage was based on the understanding that there are no known unreported claims or incidents. I also understand that all such unreported claims or incidents which later result in a claim will not be covered by the Company’s policy.