NOTICE TO APPLICANT:
WARRANT: I/We warrant that the information contained herein is true and that it shall be the basis of the policy of insurance and deemed incorporated therein, should the Underwriters evidence their acceptance of this application by issuance of a policy. I/We hereby authorize the release of claim information from any prior insurer to Underwriters. All information disclosed on this application, together with any supplementary information obtained regarding the applicant remains the exclusive property of CEM.
NOTE: In applying for coverage, the applicant agrees that in the event of covered losses, he will be required to be defended by the Underwriters' appointed lawyers, and that the deductible shall apply to loss and claim expenses, adjusting expenses, investigation costs, and legal fees. If the applicant elects to handle a claim without in any way involving the Underwriter, then no coverage for such claim is afforded the applicant under the policy.
I understand and accept that the policy applied for provides coverage on a CLAIMS FIRST MADE basis for ONLY THOSE CLAIMS FIRST MADE AGAINST THE ASSURED WHILE THE POLICY IS IN FORCE and that coverage ceases with the termination of policy unless I exercise options available and in accordance with terms of the policy.