07 April 2013

Application for Professional Indemnity Insurance

As you are aware, your assignment requires that you are covered by Professional Indemnity Insurance (PII). The purpose of this cover is to protect you from any claims for damages resulting from a breach of professional duty by way of neglect, error or omission. If you are already covered by an existing policy of insurance, kindly forward a copy of the policy certificate as soon as possible. If you do not have the necessary insurance, Access Financial Services Srl (AFSS) will provide PII cover for the duration of your assignment with us, at very competitive rates. Our Professional Indemnity Insurance is underwritten by QBE Insurance (Europe) Ltd, one of the worlds leading insurers and re-insurers. It protects you against claims for compensation by an end client for errors, omissions or negligence, for professional services you have provided worldwide, except in the United States. It covers the legal cost involved in defending any claim. It covers you for all assignments whilst you are on contract with AFSS. Under the policy, the Insurers have waived their rights of subrogation against you, meaning that Access Financial and not you will answer to the Insurers.

Please take note that, without the PII cover being in place, AFSS is not able to process your contract, which may result in delays to your payment. Kindly complete the form below and return by fax or email to: Ritsa Mavroudis Manager Insurance Services Telephone: +357 25 820 640 Fax: +357 25 341 027 Email: ritsa.mavroudis@accessfinancial.ch Application for Professional Indemnity Insurance Contractor Name E-mail address Contact phone number Policy duration please tick Start date Up to 3 months 50 4 to 6 months 100 End date 7 to 12 months 150

Signed

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