Harare Office
Ericom Communication Complex
1 Boshoff Drive
Graniteside
HARARE
Bulawayo Office
Third Floor - Charter House
Cnr. Fort Street / Leopold Takawira Avenue
P. O. Box 546
BULAWAYO
Licensed by (IPEC) and a Member of (IBAZ)
Domestic Combined Insurance Proposal
Download a TiB Insurance Domestic Combined Insurance Proposal Form
Declaration
I hereby declare that all the information provided is in all respects correct and that no material fact has been suppressed or withheld and that if such information has been provided on my behalf I agree that this declaration and the answers given shall be the basis of the contract between the Company and me. I further agree to accept the usual conditions prescribed by the Company and endorsed on their policy.
PLEASE NOTE: ORIGINAL SIGNED PROPOSAL FORM MUST BE SUBMITTED TO TIB INSURANCE BROKERS SUBJECT TO APPROVAL
