6. Are all your employees contracts entered into in the United Arab Emirates?
7. Are any of the following used in connection with your business?
8. Are you involved in any form of railway work?
9. Do you discharge any hazardous waste products (e.g. chemicals, gases, radioactive substances,
dust, fumes
or vapours) into the atmosphere, sewers, waterways or elsewhere?
If YES please advise type of waste and give full details of:
10. Do you carry out any manual work away from your own premises including outside of the
UAE?
11. Do you design, give advice or prepare specification?
12. Do you supply any products that you do not manufacture?
13. Give details of any products used:-
14. Are any of your products, currently or any in the past 3 years supplied directly or to your
knowledge indirectly to the
USA or Canada ?
15. Are any of the goods known to be potentially harmful to health or require any hazard
warning?
16. Do you have any representation outside of the UAE?
18. Have you had any claims made against you during the under noted period?
(If YES please give details)
19. Please state name of present and previous insurers over the last three years
ALL CONTRACTORS MUST COMPLETE ‘CONTRACTORS ADDITIONAL PAGE’
TO BE COMPLETED IN ALL CASES
IMPORTANT NOTICE
Failure to disclose material facts could result in your policy being invalidated. Material facts are those
facts which
might influence the acceptance or assessment of your proposal. If you are in any doubt as to whether a fact
is
material you should disclose it.
I/WE hereby declare that to the best of my/our knowledge all the statements given on this Proposal Form are
true
and complete and that I/we have disclosed all material facts that ought to be communicated to the
Underwriters.
II/WE undertake to exercise all ordinary and reasonable precautions for the safety of the insured
property.
I/WE hereby agree that this Proposal and this Declaration shall be the basis of the contract of the insurance
between the Insurers and Myself/Ourselves.
Law Applicable to Contract : If the proposer shown on this Proposal Form is a private individual or a sole
trader then they are free to choose the
law applicable to this Insurance Contract. This Contract will be subject to English Law (or Scottish Law
where applicable)
Do you undertake any work in connection with the following:-