Letter of Appointment

This application will sign over your policies to be managed by Tank Insurance.

Signature

COMPANY

8 September 2024

ADDRESS

To whom it may concern,

Whilst this Letter of Appointment is not on any letterhead I attest to its authenticity and intent in my capacity as POSITION.

Effective DATE, I appoint Tank Insurance as our insurance broker to manage our insurance policy(s) listed below for COMPANY_NAME.

Client Name: NAME/COMPANY

Client Address: ADDRESS

Appointment of Marel Pencev AR No 001305231 and any insurance broker of Tank Insurance Pty Ltd ABN 83 667 323 579 as my broker.

I have appointed the above named, Authorised Representatives of Sphere Insurance Group Pty Ltd AFSL 478959 of 5 Jellicoe Street, Toowoomba QLD 4350 to handle the above insurances on my behalf.

I authorise my current insurer(s) to provide them with all documentation and information they require regarding my insurance(s) and claims history for these classes of insurance.

This appointment replaces any existing arrangement in place between us/me and any other insurance intermediary formally appointed to advise on or arrange or negotiate our/my insurance requirements as described above.

Please Note: This authority is valid until instructed by us to terminate the same.

Yours faithfully,

NAME

COMPANY