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For Limited Companies only
Please provide the following information in respect of all Principals, Shareholders, Directors and Company
Secretary of the Company: (If a limited Company, please ignore (b) below)
Has the applicant or any Director, Principal, Partner or Senior Employee:
Professional Indemnity Insurance:
(Please enclose a copy of your current PI Certificate detailing above. Your Application cannot be processed without this document. Minimum cover required: Â£250,000)
Note to all applicants:
It is mandatory for all ATII Members to operate Client/Insurance Business Accounts
Client Bank Account
It is declared that:
a. The applicant carries on business as a supplier of travel insurance and either the applicant is a Lloyds Broker
or at least 25% of its brokerage is derived from the supply of travel insurance facilities.
b. The applicant will comply with the requirements of the Association's Memorandum and Articles of
Association, a copy of which will be supplied to the Member upon his/its appointment as a member of the
Association, or earlier on request.
TO: The Secretary
The Association of Travel Insurance Intermediaries Ltd
I/we hereby apply for membership of the Association of Travel Insurance
Intermediaries Limited ("the Association") subject to its Articles and Memorandum of
Association. Words and expressions defined therein shall have the same meaning in
I/we undertake to contribute to the assets of the Association in the event of its being
wound up while I/We am/are a member, or within (1) year afterwards, for payment of
the debt and liabilities of the Association contracted before I/we cease to be a
member, and of the costs, charges and expenses of winding up, and for the
adjustment of the rights of the contributors amongst themselves, such amount as
may be required, not exceeding one pound (Â£1); or in case of my/our liability
becoming unlimited, such other amount as may be required in pursuance of Clause
5 of the Memorandum of Association.
I/we acknowledge that the Association may impose conditions, including the
execution of certain undertakings and guarantees, on my/our membership of the
I/we represent unto the association that the matters set out in the attached
Membership Application Questionnaire hereto are true to the best of my/our
knowledge and belief.
Subject to aforesaid, I/we authorise you to enter my/our name(s) in the Register of
Members as members of the Association pursuant to this application.
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