Employer's Liability insurance

Start date of activity:
Period of insurance From
To
Is there a contract or agreement entered into between you and any government agency, company or person to carry out specific actions(named the owner of the project)?


(1)

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(5)

Specify the maximum liability required for:

Have you ever secured or currently insured employees at an insurance company?

Declaration:
I hereby confirm that the above mentioned information in the proposal is correct and in conformity with the reality, i have not made any of the essential matters related to the risk to be insured, which would affect the company's decision to accept the insurance or not, or to determine the prices and conditions on which the contract is contracted..
I also know that any incorrect or incomplete declaration becomes a voidable contract, and i accept that the insurance application and his request-based declaration are essentially a part of the contract and an integral part of the insurance policy.