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Declaration

I/We desire to insure with the Company in respect of the vehicle or vehicles described in the above proposal. I/We warrant that the above statements made by me/us or on my/our behalf are true and complete and that nothing materially affecting the risk has been concealed by me/us. I/we agree that this proposal shall be incorporated in and taken as the basis of the proposed contract between me/us and the Company and I/we agree to accept a policy in the Company’s usual form for this class of insurance. I/we undertake that the vehicle or vehicles to be insured shall not be driven by any person who to my/our knowledge has been refused any motor vehicle insurance or continuance thereof.

Agreement




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