Fidelity Insurance Proposal

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MoneyGoods

SYSTEM OF CHECK

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SCOPE OF COVER

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A) Cover for entire workforceB) Cover for employees in selected categories of occupation onlyC) Cover for named employees only
a) Staff with direct responsibility for money, stock accounts or computer operationsb) Other staff

I/We declare that these statements made by me/us or on my/our behalf are to the best of my/our knowledge and belief true and complete and shall be incorporated in the contract between me/us and the company. I/We agree to accept a policy in the Company's usual form for this class of insurance.


Signing this form does not oblige you to complete the insurance

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