Should you require higher amounts for Loss of Rent or Common Contents, please include your amended figures. • Loss of Rent is automatically calculated at 15% Common • contents is automatically calculated at 1%

Fire protection

In order for us to provide you the most competitive price, it is important that we have full disclosure of all losses in the past five years. Please attach a copy of the claims history on letterhead from the current insurer when submitting this proposal form, even if there have been no losses.

Before completing this document, I/We have read and understood the information herein, including the Important Notices and the Policy Wording and Product Disclosure Statement.

The answers given in this document and any other information supplied by the intending insured or by any other party on their behalf, are truthful and accurate.