Let’s join forces to delight your clients! Book inspirational 30-min call with us BROKERS ARE WELCOME 11.Your Details.22. Regulated Status.33. Professional Indemnity Insurance.44. Your distribution. Counterparty's full legal entity name*(Required) Type of corporation (e.g. Sole Trader; Limited Company; LLP; etc) and date established Company Registration Number AddressRegistered Address if differentTelephone numberWeb address Principle contact name, email address and telephone number Regulated Status In what country are you regulated as insurance broker:What is your insurance registration number: What is the website of Financial Inspection where you are regulated: Professional Indemnity Insurance Policy Holder: What is your current Policy PeriodFrom YYYY dash MM dash DD To YYYY dash MM dash DD Limit of Liability Aggregate for Policy period, including cost & expensesDeductible if any Policy Governing Law:Jurisdiction: Insurer Distribution How will you distribute product and in what countries: