Name of client Fees Earned Nature of work Are If you involved please in supply the manufacture, details and advise construction, what approximate alteration, repair percentage of fees are Yes earned from No “Yes”, or physical sale of products activities. other than in a consultancy capacity? % N.B. ITIC provides professional indemnity insurance not products liability insurance. Are you a member of any professional trade association? Yes No (If please detail) “Yes” SECTION 3 Contract conditions – Do you operate national or contract conditions”? Yes No “standard Do you operate under any form of service agreement”? Yes No “master If to either of the do you always advise your customers Yes No “Yes” that your standard contract conditions apply? Please supply copies of all contract conditions under which you operate. If to a) or b) please give details: “Yes” What approximate percentage of clients accept your standard form of contract? What approximate percentage of your business is subcontracted to others? SECTION 4 Insurance/claims history – Are you currently insured against the risks covered by ITIC? Yes No If answer the following. (If please give details of most “Yes”, “No” recent insurance) Name of insurer
Name of client Fees Earned Nature of work Are you involved in the manufacture, construction, alteration, repair or sale of products other than in a consultancy capacity? Yes No If “Yes”, please supply details and advise what approximate percentage of fees are earned from physical activities. % N.B. ITIC provides professional indemnity insurance not products liability insurance. Are you a member of any professional trade association? (If “Yes” please detail) Yes No SECTION 3 – Contract conditions Do you operate national or “standard contract conditions”? Yes No Do you operate under any form of “master service agreement”? Yes No If “Yes” to either of the do you always advise your customers that your standard contract conditions apply? Please supply copies of all contract conditions under which you operate. If “Yes” to a) or b) please give details: Yes No What approximate percentage of clients accept your standard form of contract? What approximate percentage of your business is subcontracted to others? SECTION 4 – Insurance/claims history Are you currently insured against the risks covered by ITIC? If “Yes”, answer the following. (If “No” please give details of most recent insurance) Yes No Name of insurer
ITIC_miscellaneous_proposal_form.docx