Declaration
On behalf of all proposed Policyholders I/We declare and agree that:
a. all information provided, in this renewal declaration or attachments, is true and complete in every respect and that no Material Facts remain undisclosed;
b. if this risk is accepted, such information will be incorporated into and form the basis of the contract of insurance;
c. I/We understand that the Insurer requires this information in order to evaluate this proposal and that the Privacy Act 2020 entitles me/us to have access to, and request the correction of, any information retained;
d. Hutchison Rodway Ltd & Quadrant PI Ltd are authorised to disclose information to the Insurer, reinsurers, other insurers and parties with a financial interest in the subject matter of this proposal;
e. The Insurer is authorised to check details against the Insurance Claims Register and to place information on the Insurance Claims Register which other insurers can access;
f. Hutchison Rodway Ltd on behalf of Quadrant PI Ltd and the Insurer are authorised to obtain from other parties any information which may be relevant to the acceptance of this risk;
g. the signing of this declaration does not bind either party to complete the contract and that no cover will be in force until confirmed by Quadrant PI Ltd, their nominated Insurance Broker and the Insurer.