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Accident Public Vehicles Business Private Vehicle Goods In Transit Fire

Accident Insurance

GROUP PERSONAL ACCIDENT INSURANCE PROPOSAL FORM
For insurance of financial aid to employees disabled by accident whether at or away from work

By submitting this form, I/We hereby warrant and declare the truth of all the above statements and that I/We have not held any material information, and I/We hereby agree to give notice to Alliance & General
Insurance Company Ltd of any variation in My/Our profession, occupation or health of any of
the persons to be insured immediately such information shall come to my/our knowledge.
I/We further agree that this Declaration shall be the basis of the contract between me/us and
Alliance & General Insurance Company Limited and to accept a Policy subject to the terms
exceptions and conditions prescribed by the Company

Commercial Vehicle

DECLARATION
I/We, the above named, being desirous of effecting an insurance, as above described, do hereby
declare that the particulars of the proposal are true, that I/We have not omitted to disclose any
material fact, and I/We further agree that this Proposal and declaration shall be the basis of the
Contract between myself/ourselves and Alliance and General Insurance Company Limited. I/We
undertake that the vehicle or vehicles to be insured will be maintained in an efficient condition.
I/We further agree to accept a policy subject to the terms, provisions and conditions of the
Company

Building Liability

PROPOSAL FORM
BUILDERS LIABILITY (OPEN) INSURANCE
(under Sec. 64 of Ins. Act 2003)

 

By submitting the form you declare that the above statement are true and correct and agree that this
proposal form shall the basis of the contract between us and the underwriter.

Motor Insurance

Goods in Transit

GOODS IN TRANSIT INSURANCE PROPOSAL FORM FOR INSURANCE OF GOODS IN TRANSIT BY ROAD, RAIL OR  INLAND WATER WAYS IN FEDERAL REPUBLIC OF NIGERIA

By submitting this form I/We desire to effect an insurance in the terms of the usual Policy for Goods In Transit Insurance
and declare that the above statements and particulars are true. I/We further declare by submitting the form that this
proposal shall be the basis of the contract between me/us and Alliance & General Insurance
Company Ltd. I/We also are aware that our failure to insure for the full value of the property will
result in I/We receiving only a proportion of any amount that may be due in the vent of a loss or
damage

FIRE INSURANCE PROPOSAL FORM

By submitting the form you declare that the above statement are true and correct and agree that this
proposal form shall the basis of the contract between us and the underwriter.

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