Letter of Appointment

We hereby appoint Rata Insure Limited as my/our Insurance Broker and they have my/our authority to act on my/our behalf with effect from today*

Yes

Name*

Company Name

Email*

This authority revokes and replaces any previous authorities given to or implied to any Agent or Insurance Broker who may have previously acted on my/our behalf.

We authorise Rat Insure Limited to request information that is held by other parties or to disclosure information to other parties in order to carry out their duties as our Insurance Broker.

We also acknowledge that and consent to:-

1. Insurers with whom you place our insurance business will provide a payment to you for doing so.

2. As part of administrating our insurance program you may also charge a service fee, which will be included in the total amount of any invoice presented to me/us for payment.

Letter of Appointment

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