LETTER OF APPOINTMENT ________________________________ hereby appoint Inscon Risk Services (PTY) LTD as their Insurance Brokers with effect from the _____/_____/20____ to handle all matters pertaining to our insurances per the attached Standard Terms of Business (Annexure A). In addition we require them to renew and/or place all relevant insurances as is necessary to ensure continuity of cover and where relevant debit our account, per the attached debit order authority (Annexure B). We hereby authorise for all policy schedules, claims experience, premium computations and any outstanding claim files to be handed over to Inscon if requested. Signed ………………………………………………….. Name ………………………………………………….. Capacity ………………………………………………….. Date ………………………………………………….. Company Reg. ………………………………………………….. VAT No. ………………………………………………….. Company Stamp Inscon Risk Services an Authorised Financial Services Provider License No. 44335 ANNEXURE A PRIVATE & CONFIDENTIAL STANDARD TERMS AND CONDITIONS OF BUSINESS (Commercial Short Term Insurance) between Inscon Risk Services (hereinafter referred to as the “FSP”) and ____________________________________________ (hereinafter referred to as the “Client”) 1. Background & Objectives  The purpose of this document is to establish a professional business relationship between the parties and to demonstrate our intention, as your FSP, to align ourselves with the main objectives of the legislation that regulates financial advisory and intermediary services.  The Financial Advisory and Intermediary Services Act, No. 37 of 2002 became effective on 30 September 2004 and the purpose of the Act and its subordinate measures is to protect consumers and to enhance the integrity of the financial services industry.  The Act requires the services to be rendered in accordance with the contractual relationship and reasonable requests and instructions from the Clients. 2. Disclosure by FSP  As your FSP we are required to disclose our full business details to you which are included in all policy documentation and/or summaries issued by our offices.  We are licensed in the Short Term Insurance category to render advice and intermediary services in Personal lines and Commercial Insurances. Our advice will therefore be limited to these categories. 3.  We will act with the degree of reasonable and proper care, skill and diligence as the circumstances of each case require of us.  We will conduct our business in good faith and with integrity. Disclosure by Client  You are obliged to disclose to insurers, before the contract is concluded, any "material" circumstances which may in any way affect the risk and, in turn, the decision of the underwriter to insure the risk. Should you not disclose material facts, a policy may be voided by the insurer, from inception. This means insurers are entitled to act as if the policy had never existed and to seek recovery of all claims already paid under that policy, although they would be obliged to repay the premium.  You will be required, in the beginning of our relationship and on an annual basis, to provide updated risk information with regard to the subject matter to be insured and claims information which will be used for the purposes of obtaining the initial cover or renewal terms from insurers and re-insurers.  We therefore will request this information from you. Should you not be prepared to supply the information the “Warning to Client” under 6 is applicable Placement of Insurance:  Any placement of insurance cover by us on your behalf will be implemented based on your specific instruction(s) and will only be in force once it has been accepted and confirmed by the insurer.  Unless otherwise agreed in writing we will endeavor to: i. Arrange appropriate cover with a quality insurer although we cannot accept responsibility for, nor guarantee, the future solvency of these insurers or re-insurers or their ability to pay claims ii. Ensure that the insurer has an appropriate claims handling ability iii. Ensure that the pricing is competitive 4. Analysis  We will perform an analysis based on the information supplied to enable us to render appropriate advice to you  We cannot be held responsible for any insurance need: i. Not disclosed to us ii. Not addressed or any recommendation not implemented by you iii. Any recommendation implemented through any other FSP 5. Warning to client  Where you the Client have not provided all the information as may be required or where we are unable to conduct an analysis as insufficient time was provided, you are warned that: i. A full analysis would not have been completed to accurately assess your insurance needs ii. There could be limitations on the appropriateness of the advice provided iii. Consideration should be made on your own, whether the advice is appropriate considering your objectives, financial situation and particular needs 6. Records of advice and confirmation of cover  In terms of the FAIS Act your FSP is required to maintain a detailed record of advice. In view of this statutory requirement we will confirm all instructions and notices in writing.  Any instruction will form the basis of a record of mutual understanding between both parties and is intended to compliment our corporate governance procedures and legislative requirements.  We undertake to maintain records of our dealings with you and on your behalf as required by law.  We will send you a policy document and/or summary within 60 days of inception of cover which sets out the various terms, conditions, warranties and exclusions relating to the cover. 7. 8. Payment of Premiums and Fees  You are responsible for the payment of the premium and fees to us on receipt of the invoice.  In the event that settlement is required, other than on presentation of our invoice, we will advise you accordingly.  Failure to pay your premium on or before the date contractually required could void your policies. Claims  Claims, losses or any circumstances which could give rise to a claim should be notified to us as soon as possible and certainly within any time limit specified in the policy.  Any notification should include all material facts concerning the claim.  Where circumstances so require we will advise you how to proceed with the quantification and settlement of your claim.  We will keep you appraised of the progress of your claim and of any special circumstances relating thereto. 10. Termination of our Appointment  This agreement may be terminated by either you or us giving 60 days notice in writing to the other, or immediately in any of the following events:  if either you or we commit a material breach of any of the terms of this agreement which is not remedied within 14 working days, except where such breach is due to a cause beyond the control of either you or us, or  if either you or we are liquidated, become insolvent, make a voluntary arrangement with creditors or have a receiver or administrator appointed.  Other than in circumstances where there has been a material breach of this agreement by us, where annual premiums are paid, whether commission or fee based, and the mandate is cancelled within 6 months of inception or of renewal, 40% of the annual fee/commission shall be refunded;  Where the cancellation takes place after 6 months, the full annual fee/commission shall be regarded as having been properly earned;  Any outstanding work following termination of this agreement, specifically outstanding claims, recoveries and other administrative matters, will be handed over to you. Arrangements can be made for us to “run off” all outstanding work subject to a separate agreement. 9. Confidentiality Your information will be handled confidentially and will only be made available with your authorisation or where we are compelled to do so by law. Claims information is shared on an industry wide basis. Signed at ___________________________________________, on this_______________________day of _______________________200__ For and on behalf of the Client (print name) ________________________________ (signature) ____________________________________(designation)_______________________ For and on behalf of Inscon Risk Services (PTY) LTD (print name) ________________________________ (signature) _____________________________________(designation)______________________ DEBIT ORDER INSTRUCTION (Annexure B) Name of Bank Branch Code Account No. Type of Account (Tick appropriate box) CURRENT TRANSMISSION Name of Account Holder (Please Print) I/We hereby authorise Inscon Risk Services (Pty) Ltd to draw against the above account (or any other Bank to which I/we may transfer my/our account), the amount necessary for the payment of the installments which may from time to time become payable by me/us in terms of my/our Loan Agreement (s). This authority shall remain in force until cancelled by me/us, giving 30 days notice in writing. Receipt of the instruction by Inscon Risk Services (Pty) Ltd shall be regarded as receipt thereof by my/our Bank. Company Registration Number:…………………………………….. Company VAT Number: …………………………………………………. Date: Signature (s) of Account Holder 1. 2.