Quotation

Quotation Number: NB201901-77524-1

Ref: 106008/158059 (SG-70713)

Comprehensive (AP)
Dated 21 March 2019

Broker / Intermediary: MARLIN HOUSE FINANCIAL LIMITED

We acknowledge your Proposal Form and supporting submission and are pleased to provide the following quotation which is
based on a proposed Policy Period 1 February 2019 to 31 January 2020.

Parties
Name of Applicant FORWARD BPO PTE. LTD. (201722266H)
Address 10 ANSON ROAD, #05-17 INTERNATIONAL PLAZA, SINGAPORE, 079903,
SINGAPORE
Insurer QBE INSURANCE (SINGAPORE) PTE. LTD. (198401363C)
1 RAFFLES QUAY, #29-10 SOUTH TOWER, SINGAPORE, 048583
Country of Issue SINGAPORE
Governing Law SINGAPORE

Pricing Conditions
Policy Currency US DOLLAR (USD)
All amounts shown in this document are denominated in the Policy Currency.
Premium Calculation Method Premium - Turnover Declaring (CA0300-00-00-S)
Total Estimated Turnover USD 6,000,000
Rate for Calculation of Premium 0.3000%
Total Estimated Premium USD 18,000

Minimum Premium USD 18,000

Premium Instalment Frequency Half Yearly
Declaration Period Frequency Not Required
Limit Management Charge USD 1,200
plus GST USD 84
Premium Incentive 5.00% No Claim Bonus - Conditional on Renewal

Page 1 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Coverage
Type of Cover Comprehensive (AP) (document attached)
Risks Attaching
Description of Trade Provider of BPO Services
Claimable Events Insolvency
Protracted Default (Protracted Default Period: 180 days)
Political Risks
Insured Percentage 90% (or as varied in the Approved Countries & Conditions Table)
Deductibles USD 5,000 Non Qualifying Loss
Maximum Policy Liability USD 900,000
Maximum Invoicing Period 30 days
Approved Claims Currency US DOLLAR (USD)

Endorsement Summary
AA0010-00-00-S Duty of Disclosure
AA0020-00-00-S Dispute Resolution
BA0040-00-00-S Loss Payee
CA0300-00-00-S Premium - Turnover Declaring
EA0015-00-00-S No Claims Bonus + conditional on renewal
JA0010-00-00-S Establishing Permitted Credit Limits
KA0010-00-00-S Non Qualifying Loss
FA0100-00-00-B Limit Management Charge - Adjustable
NA0020-00-00-S Political Risk Endorsement - (ABC)

Dated 21 March 2019

Page 2 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Approved Countries & Conditions Table

The Country specific information contained in this table may vary the Pricing Conditions and Coverage above.

All amounts shown in this table are denominated in USD. Political Risk Components

Maximum Terms of Maximum Political Risk Political Risk Maximum

Approved Discretionary Insured Waiting
Terms of Payment Extension Cover Insured Political Risk
Country Credit Limit Percentage Period
Payment Description Period Applicable Percentage Liability

Open Credit
AUSTRALIA 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

Open Credit
CANADA 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

Open Credit
CHINA (PRC) 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

Open Credit
HONG KONG 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

Open Credit
JAPAN 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

Open Credit
NEW ZEALAND 0 90% 60 days from date of 60 days Yes 90% 900,000 180 days
invoice

All terms and conditions should be read in conjunction with our Policy wording.

Please note that all Rates, Terms and Conditions are subject to capacity being available at the time of binding. QBE
INSURANCE (SINGAPORE) PTE. LTD. reserves the right to withdraw its quotation and to revise its terms. Coverage can
only be bound after an offer from the Applicant, reflecting all relevant contractual terms has been received and accepted by
QBE INSURANCE (SINGAPORE) PTE. LTD..

This quotation will remain active until 20 April 2019 and is made subject to “Nothing of an Adverse Nature Occurring” prior to
the completion of our negotiations and all elements of the proposal being fully completed.

We are not currently on risk and cannot be considered to be on risk until you have received written notice from us.

Yours sincerely,

For QBE INSURANCE (SINGAPORE) PTE. LTD.

Ritesh Sampat

Attachments:
Comprehensive (AP) Policy Wording

Dated 21 March 2019

Page 3 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)
Endorsements
(AA0010-00-00-S)
Duty of Disclosure
(AA0020-00-00-S)
Dispute Resolution
(BA0040-00-00-S)
Loss Payee
(CA0300-00-00-S)
Premium - Turnover Declaring
Dated 21 March 2019
The Insured has a duty of disclosure. Before entering into, renewing, varying, extending
or reinstating a policy the Insured is required to tell the Insurer everything the Insured
knows and that a reasonable person in the circumstances could be expected to know,
and is a matter relevant to the Insurer’s decision whether to issue a policy, and if so, on
what terms.
The Insured does not have to tell the Insurer about any matter:
that diminishes the risk,
that is of common knowledge,
that the Insurer knows or should know in the ordinary course of its business as
an Insurer, or
which the Insurer indicates it does not want to know.
If the Insured fails to comply with its duty of disclosure the Insurer may reduce or refuse
to pay a claim or cancel the policy. If the non-disclosure is fraudulent the Insurer may
also have the option of avoiding the contract from its beginning.
The Insurer will do everything possible to provide a quality service to the Insured.
However, we recognise that occasionally there may be some aspect of our service or a
decision we have made that you wish to query or draw to our attention.
We have a complaints and dispute resolution procedure which undertakes to provide an
answer to your complaint within fifteen (15) working days.
If you would like to make a complaint or access our internal dispute resolution service
please contact your nearest office of the Insurer and ask to speak to a dispute resolution
specialist.
It is hereby agreed and understood that in the event of any claim due to be paid under
this Policy the Insurer will make payment to the Loss Payee specified in the Schedule
unless waived in writing by the Loss Payee.
a. The Insurer reserves the right to withhold payment until such time as both the
Loss Payee and the Insured have confirmed their respective interests.
b. The Insured may withdraw or amend this endorsement only with the written
consent of the Loss Payee.
c. It is understood and agreed that the Loss Payee is not entitled to lodge or pursue
a claim under the Policy and will have no rights whatsoever under the Policy
other than receiving a claim payment as provided for under this endorsement.
d. The Insured agrees to indemnify and hold the Insurer harmless for any loss,
claim, damages or demand suffered or incurred by the Insurer as result of it
acting in accordance with the Insured’s instructions contained in this
endorsement.
Page 4 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)
Endorsements
(EA0015-00-00-S)
No Claims Bonus + conditional
on renewal
(JA0010-00-00-S)
Establishing Permitted Credit
Limits
(KA0010-00-00-S)
Non Qualifying Loss
(FA0100-00-00-B)
Dated 21 March 2019
Premium is payable by the instalments noted in the Premium and Instalments Schedule
and is adjustable on receipt of all Declarations due under this Policy as noted below. The
total premium payable under this Policy for the Policy Period is the greater of:
a. an amount calculated by multiplying the Turnover of Transactions by the Rate for
Calculation of Premium as specified in the Schedule; and
b. the Minimum Premium as specified in the Schedule.
Declarations
The Insured must declare its Turnover of Transactions (as defined below) for the Policy
Period in accordance with the Declaration Period Frequency noted in the Schedule.
These Declarations are to be made on the form provided by the Insurer within fourteen
(14) days after each declaration period unless otherwise required in this Policy. At the
expiry of the Policy Period and on submission of all Declarations the Insurer will calculate
the total premium payable and notify the Insured in writing of the amount due to or from
the Insured (after taking into account the total of premium instalments paid and the
Minimum Premium). In each case payment in full is due within seven (7) days of
notification.
Turnover of Transactions means the aggregate invoice value of all Shipments made by
the Insured to Insured Buyers at any time during the Policy Period, but excluding the
invoice value of any indebtedness which is not covered in this Policy by Exclusions.
The Insurer agrees to allow the Insured a No Claims Bonus (as specified in the
Schedule) ("NCB") on the total premium earned during the Policy Period subject to:
a. no claim(s) being paid in respect of this Policy Period; and
b. the Policy is renewed for a further period.
In the event of any claim arising, the Insured must submit such claim(s) for assessment
and advice of the potential liability by the Insurer, in accordance with the terms and
conditions of the Policy. The Insured may defer the decision of availing of the claim
payment(s) or the NCB but must communicate to the Insurer its decision in writing no
later than twelve (12) months from the end of this Policy Period. Once a NCB is claimed
from and paid by the Insurer, it will be irrevocable and the Insured is not entitled to any
claim payments for losses arising under this Policy Period.
A Permitted Credit Limit must be established in respect of each Insured Buyer by the
Insurer issuing a Credit Limit Endorsement.
The Insured must offer every buyer to the Insurer in accordance with the terms and
conditions of the Policy or as otherwise amended.
When any Claimable Event occurs no liability will attach to the Insurer in respect of the
indebtedness of an Insured Buyer to the Insured unless the Insured Loss, after the
deduction of the value of all applicable Policy exclusions, at the Claimable Event Date is
in excess of the Non Qualifying Loss specified in the Schedule.
The Insured will pay the Limit Management Charge noted in the Schedule which is non-
Page 5 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)
Endorsements
Limit Management Charge -
Adjustable
(NA0020-00-00-S)
Political Risk Endorsement -
(ABC)
Dated 21 March 2019
refundable. This charge may be increased subject to the level of Credit Limit
Endorsement activity during the Policy Period. The adjustment will be calculated by
multiplying the number of Credit Limit Endorsement approvals during the Policy Period
by 100 but always taking into consideration any non-refundable Limit Management
Charge already paid or due to be paid.
Subject to the terms and conditions of the rest of the Policy, except as amended by this
Political Risk Endorsement, the Insurer by the addition of this Political Risk Endorsement
agrees to extend cover to indemnify the Insured up to the Political Risk Insured
Percentage of the Insured Loss in the event that the Insured Buyer fails to or is
prevented from remitting from the country of the Insured Buyer to the Insured an Insured
Debt within the relevant Waiting Period for such country specified in the Approved
Countries & Conditions Table by reason of the following additional Claimable Events:
A. Inconvertibility;
B. Contract Frustration, Contract Cancellation, Export Restriction or Import
Restriction (collectively referred to as Insured Peril(s));
C. Public Buyer Default.
This extended cover is referred to generally as Political Risk coverage.
CONDITIONS
1. Consultation
In the event of any occurrence which may give rise to a loss under this Political Risk
Endorsement, the Insured must notify the Insurer in writing with the least possible delay
and must take all steps required by the Insurer in connection with any loss which the
Insured may have incurred or may be likely to incur including, if so required by the
Insurer, the execution of such documents and the taking of such action as may be
necessary to enable the Insurer to intervene directly in the proceedings relating to the
Insured Debt.
2. Waiting period and Claimable Event Dates
The Insurer will not be liable for any loss under this Political Risk Endorsement until the
expiry of the relevant Waiting Period specified in the Approved Countries & Conditions
Table in the Schedule, such Waiting Period to commence from the relevant Claimable
Event Date which will be:
A. for Inconvertibility, at the date of local deposit of the then local currency
equivalent of such Insured Debt or the completion of formalities necessary in
order to obtain due transfer from the local currency of the deposit made to the
Insured, whichever is the later;
B. for Insured Peril(s), at the date of occurrence of an Insured Peril or the date on
which it has become apparent to the Insured and been advised to the Insurer that
due performance of a contract has been directly prevented by an Insured Peril,
whichever is the later date;
C. for Public Buyer Default, at the due date of payment of the Insured Debt.
3. Claims
When a Claimable Event occurs under this Political Risk Endorsement the Insured must
submit a claim under the Policy within six (6) months of the date of such Claimable
Event. Subject to the Recoveries condition of this Political Risk Endorsement and of the
Policy and after taking into account any interim payments and Recoveries and any
applicable deductible, the Insurer will pay to the Insured the Political Risk Insured
Percentage of the Insured Loss within sixty (60) days after either receipt of the claim
from the Insured or the expiry of the Waiting Period whichever is the later.
Page 6 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Endorsements

4. Recoveries
For the purpose of this Political Risk Endorsement, upon collection or realisation by the
Insured or by the Insurer of any Recoveries in respect of an Insured Buyer the amount
collected or realised (less any amounts in excess of the total indebtedness required by
law to be paid to the Insured Buyer) is to be divided between the Insured and the
Insurer, the Insurer being entitled to such proportion thereof as the Political Risk Insured
Percentage of the Insured Debt bears to the loss in respect of the Insured Buyer on the
Claimable Event Date or the date for notification under the consultation condition of this
Political Risk Endorsement whichever is the earlier. This condition applies
notwithstanding that the amount of such Recoveries, by reason of exchange rate
fluctuations or for any other reason whatsoever, exceeds any amount previously paid by
the Insurer to the Insured under the indemnity provisions of this Policy.

5. Local Currency Deposit

For the purposes of this Political Risk Endorsement if delays or difficulties are
experienced in obtaining payment from any of the approved countries included in the
Policy due to exchange transfer restrictions the Insured must call on the Insured Buyer
concerned to pay to the Insured’s account (or deposit irrevocably with a bank in the
country of the Insured Buyer for the account of the Insured) at due date of payment of
such Insured Debt the then local currency equivalent of the contract value of the goods.

6. Aggregate Liability
The aggregate liability of the Insurer under the Policy in respect of any Insured Buyer will
not exceed the Political Risk Insured Percentage of the Permitted Credit Limit applicable
to that Insured Buyer.

7. Exclusions applicable to this Political Risk Endorsement

Any loss or losses arising out of the following are excluded from the cover extended
under this Political Risk Endorsement:

a. disputes between the Insured and the Insured Buyer;

b. the failure of the Insured or their agents to fulfil any of the terms and conditions of
the contract;
c. the failure of the Insured or their agents to comply with local laws and regulations
of which they should reasonably have been aware unless prevented from so
doing by a law, order, decree or regulation in force in the country of the Insured;
d. war (whether before or after the outbreak of hostilities):
1. between any of the following five powers: China, France, United
Kingdom, Russian Federation and the United States of America; or
2. between the country of the Insured Buyer and the country of the Insured;
e. the Insolvency or financial default of any party or person whatsoever except the
Insured, the Insured Public Buyer or the central bank (or the equivalent official
foreign exchange trustee authority as approved by the Insurer) of the country of
the Insured Buyer;
f. currency fluctuations and/or devaluations including but not limited to any shortfall
between the Insured Debt and the value of the local deposit at the date of deposit
or at the date of completion of transfer formalities, whichever is the later;
g. third country trading risks where any country that is not an approved country or
the country of the Insured unless specifically agreed by the Insurer on the Credit
Limit Endorsement applicable to the Insured Buyer.

DEFINITIONS

Contract Frustration is a Claimable Event and means the direct prevention of the due
performance of a contract as a result of the occurrence within the country of an Insured
Buyer of war (except as hereinafter excluded), civil war, insurrection, rebellion and/or

Dated 21 March 2019

Page 7 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Endorsements

revolution.

Contract Cancellation is a Claimable Event and means any measure or decision of the
government of an Insured Buyer’s country which directly prevents the due performance
of a contract between the Insured and an Insured Buyer.

Export Restriction is a Claimable Event and means the cancellation (or the
nonrenewal) of a previously valid export licence or the implementation of a law or order
which directly prevents the due performance of a contract between the Insured and an
Insured Buyer.

Import Restriction is a Claimable Event and means the cancellation of a previously

valid import licence or the implementation of a law or order which directly prevents the
due performance of a contract between the Insured and an Insured Buyer.

Inconvertibility is a Claimable Event and means when events occur in the country of
the Insured Buyer or legislative or administrative measures are taken in the country of
the Insured Buyer which prevent, restrict or delay due transfer of an Insured Debt for a
period which exceeds the relevant Waiting Period for such country specified in the
Approved Countries & Conditions Table, provided always that the Insured Buyer has
paid to the Insured’s account (or has deposited irrevocably with a bank in the country of
the Insured Buyer for the account of the Insured) at or within thirty (30) days of due date
of payment of such Insured Debt the then local currency equivalent of such Insured
Debt, unless the Insured Buyer is prohibited from making the deposit by a law, or by an
order, decree or regulation having the force of law or any administrative act the effect of
which is substantially equivalent thereto, of the Insured Buyer’s country.

Insured Public Buyer is an entity carrying on business in any of the countries specified
in the Approved Countries & Conditions Table and which the Insurer has accepted by the
issuing of a Credit Limit Endorsement and is at least one of the following criteria:

a central government or a ministry, department or agency thereof (hereinafter

referred to as “government”);
a regional or local authority or a department or agency thereof (hereinafter
referred to as “local authority”);
a nationalised undertaking (including a public corporation) or a state trading
organisation or an entity which the government or local authority directly controls
provided always that the government or local authority has clear, explicit and
constitutionally sanctioned financial responsibility and a fundamental commitment
to the continuing existence of such undertaking, corporation, organisation or
entity;

but always excluding any buyer where the Permitted Credit Limit specified by the Insurer
is “nil” or where the country of the Insured (including any Joint Insured if they are the
original seller) is the same as the country of the buyer.

Insured Loss

A. In the case of Inconvertibility, the Insured Loss means so much of an Insured

Debt as equals the value of the local deposit made by the Insured Buyer at the
date of deposit or at the date of completion of the necessary transfer formalities,
whichever is the later, taking into account the whole of any Recoveries relating
thereto.
B. In the case of an Insured Peril(s), the Insured Loss means so much of an Insured
Debt as is unpaid at the occurrence of the Insured Peril or at the expiry of the
Waiting Period, whichever is the lesser amount, taking into account the whole of
any Recoveries relating thereto.

Dated 21 March 2019

Page 8 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Endorsements

C. In the case of Public Buyer Default, the Insured Loss means so much of an
Insured Debt as remains unpaid by the Insured Public Buyer at the due date for
payment of such debt or at the expiry of the Waiting Period, whichever is the
lesser amount, taking into account the whole of any Recoveries relating thereto.

Maximum Political Risk Liability represents the maximum aggregated amount of claim
payments available under this Political Risk Endorsement for all Political Risk Claimable
Events in the relative approved country and when this limit has been exhausted the
Insured is not entitled to submit any further Political Risk claims for that approved country
under this Policy. Any Maximum Political Risk Liability is part of and is not additional to
the Maximum Policy Liability.

Public Buyer Default is a Claimable Event and occurs when an Insured Buyer is an
Insured Public Buyer and fails to pay to the Insured all or part of an Insured Debt within
the relevant Waiting Period for that country specified in the Approved Countries &
Conditions Table.

Recoveries for the purpose of this Political Risk Endorsement means the value of all
goods recovered (whether under retention of title or otherwise), all monies (including
dividends paid or payable out of the insolvent estate of the Insured Buyer), securities,
indemnities, guarantees, rights of action, counter claims, set-offs or other advantages
held, received by, or due to the Insured or otherwise available for the purpose of
reducing the amount of any loss in respect of an Insured Buyer which has not been paid
at the Claimable Event Date.

Dated 21 March 2019

Page 9 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Credit Limit Indications

Requested Approved
Company (CID) National ID Comments
Credit Limit Credit Limit

LIGHTSPEED POS INC (1036012)

700 RUE SAINT-ANTOINE E
BUREAU 300, MONTRÉAL, PQ (Duns) 247619799 USD 150,000 USD 80,000
H2Y 1A6,
CANADA

FLITWAYS TECHNOLOGY INC.

(1049519)
600 CORPORATE POINTE, (Duns) 080421333 USD 19,000
CULVER CITY, CA 90230,
UNITED STATES

GLOBAL SHOP DIRECT PTY

LTD (200872)
'UPPER DECK' SUITE 57, 26-32
(ACN) 100427156 USD 200,000 USD 200,000
PIRRAMA ROAD, PYRMONT,
NSW 2009,
AUSTRALIA

CHOICE CONNECT PTY LTD

(1049516)
23 ASHMEAD AVENUE, CASTLE (ACN) 146813014 USD 2,000 USD 2,000
HILL, NSW 2154,
AUSTRALIA

BIT TRADE LIMITED (1049515)

UNIT 202, 35-39 LIVERPOOL
STREET COMMERCE (ACN) 163237634 USD 18,000 USD 18,000
BUILDINGS, SYDNEY, NSW 2000,
AUSTRALIA

BRAND DEVELOPERS LIMITED

(265820)
LEVEL 1, 519-521 LAKE ROAD, 002435475 USD 230,000 USD 200,000
TAKAPUNA, AUCKLAND,, 0622,
NEW ZEALAND

FINANCE ADMINISTRATORS OF
AUSTRALIA PTY LTD (1049510)
'TARINGA CENTRAL' UNIT 2, 165
(ACN) 079378377 USD 38,000 USD 38,000
MOGGILL ROAD, TARINGA, QLD
4068,
AUSTRALIA

ADVANCED DERMATOLOGY
CORPORATION (1049532)
C/O: NERINE TRUST COMPANY
(Duns) 815500551 USD 9,000
(BVI) LIMITED, NERINE
CHAMBERS, ROAD TOWN,
VIRGIN ISLANDS (BRITISH)

CARVIEW CORPORATION
(1049530)
1-3, KIOICHO, TOKYO GARDEN
TERRACE KIOICHO KIOI 2010001047599 USD 49,000 USD 49,000
TOWER 22F., CHIYODA-KU, 102-
0094,
JAPAN

MY SOCIAL BOOK (1049527)

5/F., DAH SING LIFE BUILDING,,
99-105 DES VOEUX ROAD, (Duns) 1845365 USD 7,000
CENTRAL,,
HONG KONG

NOVIGI PTY LTD (1049538)

LEVEL 14, 5 MARTIN PLACE,
(ACN) 613812909 USD 1,000 USD 1,000
SYDNEY, NSW 2000,
AUSTRALIA

RICHMOND GROUP FINANCIAL

SERVICES PTY LTD (1049536)
58 GIPPS STREET,

Dated 21 March 2019

Page 10 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Requested Approved
Company (CID) National ID Comments
Credit Limit Credit Limit

COLLINGWOOD, VIC 3066, (ACN) 618935612 USD 41,000 USD 41,000

AUSTRALIA

SHANGHAI HAIZHI ONLINE

NETWORK TECHNOLOGY CO.,
LTD. (1049533)
ROOM A1-4057, NO.58, FUMIN
ACCESS ROAD, HENGSHA
91310230MA1JX23M02 USD 26,000 USD 26,000
TOWNSHIP, CHONGMING
DISTRICT(HENGTAI ECONO MIC
DEVELOPMENT AREA,
SHANGHAI), SHANGHAI, 201914,
CHINA (PRC)

Dated 21 March 2019

Page 11 of 12
Quotation
Quotation Number: NB201901-77524-1
Ref: 106008/158059 (SG-70713)

Process to bind this offer

In order to bind this offer please provide specific instructions as to when you wish your policy to commence by printing this
page and completing the form below giving full details to each section. When returned, the insurer will assess your request
and provide written confirmation by way of issuing an on-risk confirmation or policy document. You are not covered until you
receive this on-risk acknowledgment. Please read the following carefully before signing.

Applicants’ Request
We confirm that we have been provided with all policy documentation. We would like to request commencement of the policy
based upon the terms and conditions of this quotation with effect from the start date of __________.

We understand that the credit limits indicated as available and any special conditions imposed which have been agreed to
date, are to be effective retrospectively from the commencement date shown above unless otherwise advised by the Insurer.

We understand that cover will not be available in respect of any buyer whose account at the date signed below is either
overdue beyond the Maximum Extension Period or where we have knowledge of any other notifiable event which is
reportable under the Policy.

We have no buyers which currently fall into these categories.

Buyers that currently fall into these categories are provided in the attached:
(please tick the appropriate box above and attach documents)

Please provide our policy documents to confirm that our contract is on risk.

Signed on behalf of all Applicants*:

___________________________________________________ [optional] Company Stamp:

Name:______________________________________________
(Please print name)

Position:_____________________________________________

Date signed: ___________

* The signatory warrants that they are a duly authorised representative of the Applicant with the authority to sign on
behalf of all Applicants to be insured under this policy.

Dated 21 March 2019

Page 12 of 12