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.