I have read and checked the application form and agree its contents. I declare that the information provided is to the best of my knowledge correct and complete. I agree that if the risk is accepted, I undertake to pay the premium when called upon to do so. I understand that my information may also be disclosed to regulatory bodies for the purposes of monitoring and / or enforcing the Underwriter's compliance with any regulatory rules or codes. I agree that I have instructed Phillips Schroeder Surety Limited to place this bond on our behalf.