Page 377 - Driving Ban Simulation 1

Telephone :0J 843 594477
Fax :01843 594488
facts.pdf
Policyholder: Mr Simon Cordell
Policy ref: COSX14MT05
STATEMENT OF FACT (vl.02)
➢ Please note that the documents enclosed relate to a "Statement of Fact" insurance policy.
➢ This means that Broadsure Direct have prepared the documentation on your behalf, based on the information
provided by you.
➢ It is vitally important that you check all the enclosed documentation to ensure that it is correct and that the
policy meets your requirements.
➢ Please complete & return declaration below within seven days.
➢ I have checked the Statement of Fact and all related documentation that the information is correct, and the
policy meets my requirements.
Print
I UNDERSTAND THAT SHOULD ANY OF THE INFORMATION WITHIN THIS STATEMENT BE
INCORRECT, IT IS MY RESPONSIBILTY TO CONTACT BROADSURE DIRECT IMMEDIATELY
ON 01843 594477 AND OBTAIN CONFIRMATION THAT THESE AMENDMENTS HAVE BEEN
COMPLETED.
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