AG-AD-

F44
REV : C

Our Ref : <branch reference no.>

Date : <date>

<agency name>
<address 1>
<address 2>
<address 3>
<address 4>

Dear Sir / Madam

APPOINTMENT OF AGENCY

We refer to your agency application with us and are pleased to inform you that your application has been
approved subject to the following terms and conditions.

1. STATUS OF APPOINTMENT

You will be appointed in the status of an Agent.

2. COMMISSION AND ACCEPTANCE LIMIT

As per list attached.

3. SUBMISSION AND PAYMENT

All motor premium will have to be strictly based on Cash Before Cover (CBC). Premium must be
remitted in full within seven ( 7 ) days from date of collection or inception of the policy, whichever is
earlier. You are required to submit all completed proposal forms, copies of cover notes and
submission sheet (s) together with the payment.

You will enjoy a credit period of 60 days for your non-motor according to the Premium Warranty. And
submission of Non-Motor proposal forms and copies of cover notes must be submitted within
fourteen (14) days of issuance.

4. PORTFOLIO MIX

The portfolio mix of your business should be as follows :-

MOTOR : %

NON-MOTOR : %

5. AREA OF OPERATION

To keep in line with the company policy of operation by areas, your area of operation for canvassing
motor business will be strictly restricted to :-

MOTOR : <state>

NON-MOTOR : Malaysia
 AMGENERAL INSURANCE BERHAD Continuation Sheet

6. INDEMNITY

Guarantor(s) of your Company will be required to sign a joint indemnity for all premiums due.

7. AGENCY CODE

Your agency/accounts code with the Company would be as follows :-

MOTOR : XXXXXX-00 MT

NON-MOTOR : XXXXXX-00 NM

Please note that all business must be conducted strictly in accordance to the terms and conditions
stipulated in our Motor and Non-Motor Underwriting Guide enclosed herewith. The Underwriting
Guide is solely for your own use and not to be distributed to other parties. Any deviation from the
Underwriting Guide would be construed as a breach of our Agency Appointment.

8. CONDITION PRECEDENT TO THIS AGREEMENT

This Appointment is conditional upon acceptance of registration of the Agent with Persatuan Insurans
Am Malaysia (PIAM) under its General Insurance Agents Registration Regulations (GIARR). In the
event the Agents registration is not accepted under the GIARR by PIAM, then this Agreement shall
be terminated without liability of compensation to the Agent by the Company

If the above terms are acceptable to you, kindly return the Duplicate Copy of this letter duly acknowledged
together with the following documents within seven (7 days) from the date of this appointment :

1 Agency Agreement
2 Guarantee & Indemnity

We look forward to a good and lasting relationship and hoping that you will extend your fullest co-
operation and support to us for both our mutual benefit.

Thank you.

Yours faithfully

<Branch Managers Name>

<Designation, Branch>

We accept/do not accept the above appointment.

..............................................
Signature/Companys Stamp
Name :
Nric No :
Date :
Encls
AGENCY :

ACCOUNT CODE :

EFFECTIVE DATE :

COMMISSION TERMS & ACCEPTANCE LIMITS

CLASS OF RISK AUTHORITY LIMIT COMMISSION

MOTOR PRIVATE CAR 400,000 10%

COMMERCIAL VEHICLE 300,000 10%
SPECIAL TYPES 300,000 10%
MOTORCYCLE 75,000 10%

FIRE CLASS 1 500,000 15%

CLASS 2 300,000 15%
CLASS 3 10,000 15%
HOUSEOWNER 3,000,000 15%
HOUSEHOLDER 50,000 15%

WORKMEN COMPENSATION ANY OCCUPATION DESCRIBED IN THE TARIFF 25%

/EMPLOYERS LIABILITY EXCEPT THOSE EXCLUDED UNDER THE 25%
COMPANYS UNDERWRITING GUIDE.

PERSONAL ACCIDENT OCCUPATION 1 500,000 25%

OCCUPATION 2 300,000 25%
OCCUPATION 3 100,000 25%

ANYONE CONVEYANCE 200,000

SCHOOL CHILDREN 10,000 25%
(GROUP)

WEEKLY CLASS 1 MAX 500

CLASS 2 MAX 300
CLASS 3 MAX 200
MEDICAL CLASS 1 MAX 5,000
CLASS 2 MAX 3,000
CLASS 3 MAX 1,000

PUBLIC LIABILITY 250,000 25%

BURGLARY 100,000 25%

ALL RISK PERSONAL EFFECTS REFER 25%

BUSINESS PREMISES 100,000 25%

EQUIPMENT ALL RISKS 100,000 25%

AGENCY :

ACCOUNT CODE :

CLASS OF RISK AUTHORITY LIMIT COMMISSION

FIDELITY GUARANTEE REFER 25%

MONEY-IN TRANSIT 50,000 25%

MONEY-IN PREMISES 50,000
MONEY-IN LOCKED DRAWERS 3,000

GOODS IN TRANSIT 50,000 15%

GOLFERS REFER 25%

PLATE GLASS REFER 25%

OTHERS REFER REFER

MARINE CARGO REFER 15%

MARINE HULL REFER 15%

BOND/GUARANTEES REFER 10%

ENGINEERING REFER 15%

PROFESSIONAL INDEMNITY REFER REFER

CREDIT PERIOD - MOTOR - CASH BEFORE COVER

NON-MOTOR TARIFF RATED - 60 DAYS
OTHERS - 60 DAYS
BANK. INSURANCE GUARANTEE - CASH TERM (UPON
RELEASE OF DOCUMENTS)

PREPARED BY : DATE :

APPROVED BY : DATE :

REMARKS :