About Us
Rothbury Insurance BrokersOur Vision and ValuesMeet Our TeamNewsOur Leadership TeamOur Board MembersRothbury GroupKiwibank TeamClient Satisfaction Rating亚洲部 - Asian Broking
Resources & Support
My Rothbury AppClient Authority FormsMake a PaymentPay by InstalmentComplaintsPublic DisclosureInsurer PartnersClient Newsletters
Careers
Working HereVacancies
Claims
Make a ClaimMotor Glass ClaimsOur Claims TeamClaim Forms
Search
Insurance Solutions
Contact Us
About Us
Rothbury Insurance BrokersOur Vision and ValuesMeet Our TeamNewsOur Leadership TeamOur Board MembersRothbury GroupKiwibank TeamClient Satisfaction Rating亚洲部 - Asian Broking
Resources & Support
My Rothbury AppClient Authority FormsMake a PaymentPay by InstalmentComplaintsPublic DisclosureInsurer PartnersClient Newsletters
Careers
Working HereVacancies
Claims
Make a ClaimMotor Glass ClaimsOur Claims TeamClaim Forms
Search
Insurance Solutions
Find a Broker
Our expert insurance solutions
Business InsuranceSpeciality InsurancePersonal Insurance
View all Business Insurance
Association Liability InsuranceBusiness Assets InsuranceBusiness Interruption InsuranceCommercial Motor Vehicle InsuranceContract Works InsuranceCyber Liability InsuranceDirectors & Officers Liability Insurance
Employee Benefits InsuranceEmployers Liability InsuranceFidelity InsuranceManagement Liability InsuranceProfessional Indemnity InsurancePublic Liability InsuranceStatutory Liability Insurance
View all Speciality Insurance
Aviation InsuranceBodies Corporate InsuranceBusiness Insurance PackageChildcare, Daycare and Play CentresChurch and Mission-based Organisations InsuranceCommercial Property ManagersFlorists InsuranceGrocer GuardHairdressers and Beauty SalonsInterflora Members InsuranceIT Contractors and CompaniesLloyd’s CoverholderNZ Heavy Haulage Association Insurance
Master Painters InsuranceMENZSHEDMotel Owners and OperatorsMotor Vehicle DealersNon-Profit InsurancePhotographersPsychologists, Psychotherapists and CounsellorsRural Contractors InsuranceTaxi Drivers4WD Off-Road InsuranceMilestone HomesJennian Homes
View all Personal Insurance
Home InsuranceContents InsuranceVehicle InsuranceBoat and Jet Ski InsuranceTravel InsurancePrivate Client Insurance
Resources & SupportClient Authority FormsAuthority to Provide Quotation

Authority to provide quotation

To the insurers concerned

This letter confirms that I/​we have authorised Rothbury Insurance Brokers to examine our insurances, prepare a report and provide a quotation. Accordingly, we ask that you please supply to them all necessary information including claims history, underwriting details, sums insured and other information to allow this to happen.

I/​we understand that this is an authority to report and quote only. If the report and quotation supplied is acceptable, then I/​we will instruct Rothbury to put insurance cover in place and begin acting as my/​our insurance broker. 

In agreeing to a quotation and having Rothbury act as my/​our insurance broker, I/ we accept Rothbury’s current Terms of Business.

Postal Address
I agree to all the terms described above the form. *
Insurance Solutions
  • Business Insurance
  • Speciality Insurance
  • Personal insurance
Resources & Support
  • My Rothbury App
  • Make A Claim
  • Make A Payment
  • Pay By Instalment
  • Client Authority & Forms
  • Disclosure Statement
  • Insurer Partners
  • Blog
  • Client Newsletters
Enquire
  • Enquire Now
  • Client Feedback
  • Complaints
  • Careers
Contact
  • Find A Broker
  • Meet Our Team
  • Our Domestic Team
  • Our Claims Team
Your insurance cover
at your fingertips
Follow us
© Copyright Rothbury Insurance Brokers 2025

Privacy PolicyTerms & ConditionsPublic DisclosureTerms of BusinessStaff LoginsRothbury Cloud Desktop