TERMS & CONDITIONS and NOTICE CONCERNING PERSONAL INFORMATION

Where (a) an applicant of this contract gives false particulars to the prejudice of the Insurer or knowingly misrepresents or fails to disclose any fact in any part of this application required to be stated therein; or (b) the Insured contravenes a term of the contract or commits a fraud; or (c) the Insured willfully makes a false statement in respect of a claim, a claim will become invalid and the Insured’s right to recovery is forfeited.

The Applicant has reviewed all parts and acknowledges that all information is true and correct and understands that this is based on the truth and completeness of this information.

The Applicant has stated and warrants that the equipment forming the subject matter of this insurance is used solely for personal purposes.

By purchasing insurance from Duliban Insurance Brokers (“the Company”), you provide the Company with your consent to the collection, use and disclosure of your personal information, including that previously collected, for the purpose of: communicating with you; assessing your application for insurance and underwriting your policies; evaluating claims; detecting and preventing fraud; analyzing business results; and acting as required or authorized by law. We do not sell or otherwise market your personal information to third parties. You may withdraw your consent, but doing so may prevent us from providing you with the requested product or service. You can obtain further information about the Company “Personal Information Protection Policy” at the Company website “www.dulibaninsurance.com” or from our Privacy Officer at the Company head office, 7-165 Hwy 20, Fonthill, ON L0S 1E5.

MINIMUM RETAINED POLICY PREMIUM

This policy is subject to a non-refundable minimum premium of $150.