• Authority to Quote

  • To the Insurer(s) concerned, 

    This letter confirms that I/We hereby authorise Venture Insurance Brokers Limited to obtain and use all necessary information, including personal information, required to enable them to consider my/our general insurance requirements and obtain quotations for my/our general insurance policies/programme.

    This includes, but is not limited to, obtaining information from previous insurers and passing it onto Insurers involving in or who may be interested in quoting for and becoming involved in my/our general insurance program.

    I/We further request that you release all particulars of my/our general insurance program (including risk management and claims information) to them and render any assistance they may require.

    I/We further consent to you sending me/us commercial electronic messages at any time in the future.

    I/We understand this is an authority to report and quote only. It is not an authority to act as Broker. If the report and quotation supplied is accepted, then I/We will sign a Letter of Appointment to Act as Broker.

  • Client Type*
  • Insured Name(s)*

  • Insured / Company name cannot contain “,*,:,,?,/,|, Please check your response

  • Is this a Trust?*
  • Trustee Name(s)*
  • Policy Number(s)*
  • Insured/Company Name(s)*

  • Insured / Company name cannot contain “,*,:,,?,/,|, Please check your response

  • Policy Number(s)
  • Date
     / /

  • We collect, use, disclose and hold your personal information in accordance with the Privacy Act 2020 and our privacy policy is available at https://cbnnz.nz/privacy-policy/ or by requesting a copy

  • Should be Empty: