Declaration and undertaking
DECLARATION AND LETTER OF INDEMNITY
To: Sompo Insurance Singapore Pte Ltd, 50 Raffles Place #03-03 Singapore Land Tower Singapore 048623
I/ We submit herewith my/our application for the selected coverage to be issued in connection with my/ our employment of a domestic maid and hereby declare that all the above particulars are true and correct. This proposal shall be the basis of the contract between me/ us and Sompo Insurance Singapore Pte Ltd (hereinafter referred to as "the company"). In consideration of the company agreeing at my/ our request to provide a Letter of Guarantee as security for the due and satisfactory performance of all conditions under the Guarantee (as selected above) for:
- the sum of $5000.00 to the MINISTRY OF MANPOWER OF SINGAPORE
- The sum of $2000/ $7000 (whichever selected) to the PHILIPPINES OVERSEAS LABOUR OFFICE (P.O.L.O) in Singapore
I/ We hereby agree and undertake as follows:-
1. to jointly and severally indemnify the Company on demand in full against all claims payments demands actions suits proceedings losses liabilities costs interests and expenses whatever which may be taken or made against them or incurred or become payable by them under the liability or obligations of the Guarantee.
2. that the Company may in its absolute discretion compromise all claims payments demands actions suits proceedings losses liabilities which may be taken or made against them under the Guarantee, and to accept all receipts vouchers and other evidence of all payments made by the Company or of all liabilities or obligations incurred by them by reason of the Guarantee as conclusive evidence against me/ us and my/ our estate of the fact and extent of my/ our liability herein;
3. notwithstanding the above, I/ We further agreed to pay the Company, interest based on the rate of 6% per annum on all sums paid by them under the Guarantee calculated form the date when payment was made until the date when I/ we reimburse them, and to pay on Indemnity Basis, all costs incurred by the Company in the course of pursuing legal proceedings to enforce their rights under this indemnity against me/ us.
4. that this indemnity shall be a continuing indemnity and the Company may at any time or times at their discretion without giving any notice to me/ us extend the validity of the Guarantee without discharging or impairing my/ our liability under this indemnity.
5. that no delay or omission on the part of the Company in excising any right, power, privilege or remedy in respect of this indemnity shall impair such right, power, privilege or remedy. The rights, powers, privileges and remedies provided in the indemnity are cumulative and not exclusive of any right, powers, privileges and remedies provided by law.
6. that this indemnity shall be governed and construed by the laws of the Republic of Singapore and I/we irrevocably submit to the jurisdiction of the Courts of the Republic of Singapore.
8. to abide by the terms, conditions and exclusions and confirm that information give in this form is true and complete.
Each and every person seeking to be insured warrants and declares that:
1. I / We have received, read or been advised and understood, the contents of the PolicyTerms and Conditions and any information material relating to this insurance product.
2. I / We understand and agrees that this insurance is in force only if an application is accepted by Sompo Insurance Singapore Pte Ltd, premium payment received in full and a Policy document is issued.
3. The information given and answers to questions in this application are true and correct to the best of my / our knowledge and have not withheld any facts likely to influence Sompo Insurance Singapore Pte Ltd's assessment of this application. My liability hereunder is irrevocable and shall remain in full force or effect until the Company’s liability under either or both the Guarantees is discharged.
4. I / We agree and authorize any hospitals, clinics, insurance companies or any other organization to release to Sompo Insurance Singapore Pte Ltd at any time any information concerning the Insured Person if required.
5. By submitting my / our information through this Application or through other means, I / We agree that the information may be used and disclosed by Sompo Insurance Singapore Pte Ltd to individuals / organisations associated with Sompo Insurance Singapore Pte Ltd or any selected third party (within or outside Singapore) for any matters relating to this application, for the purpose of processing claims, and to provide advice or information concerning products and services which Sompo Insurance Singapore Pte Ltd believes may be of interest to me / us and to communicate with me / us for any purpose.