Category with enquiry forms 1 Profession2 Risk Details3 Business Conduct4 Financial Position5 Claims History6 Insurance Cover Profession or Project TypePlease Choose One*Solicitors & LawyersReal Estate Agents & ValuersFinancial AdvisorsConstruction ConsultantsAccountantsSingle Project Risk Details1. Please provide the following detailsa. Title of ProjectLocation Street Address Address Line 2 ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country c. Estimated total contract value of projectd. Estimated total contract value for all of you to be included for this insurancee. Estimated gross fee income of portion of project to be received by all of you to be included for this insurancef. Name of Principalg. Type of projectConventional ContractDesign and Build ContractManagement ContractOthers (Please elaborate)If "others", please specifyh. Brief description of project (Please also provide full details of the contractual scope of work, contract matrix/structure and conceptual design drawing via attachment)Upload contractual scope of work, contract matrix/structure and conceptual design drawingAccepted file types: jpg, png, pdf, jpeg, doc, docx.2. Please summarise the expected time schedule for the projectDesign PhaseStart Date End Date Construction PhaseStart Date End Date Maintenance PhaseStart Date End Date Discovery/ Extended Reporting PeriodStart Date End Date 3) Please categorise all the professional services required to be performed by you or on your behalf in connection with this project Activity Total Gross Fees* including any amount subcontracted ($) Fee sub-contracted ($) Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 4. Which of the following professional duties are required to be performed by or on behalf of you within the provisions of the contract?a. Administrating retention fundYesNob. Agreeing clearing, forwarding and customs duesYesNoc. Approval of detailed design/drawingsYesNod. Arranging site insuranceYesNoe. Authorising progress paymentsYesNof. Cash flow forecastsYesNog. Certifying final payment/completionYesNoh. Co-ordination/expeditingYesNoi. Cost estimatesYesNoj. Design criteriaYesNok. Drafting contract conditionsYesNol. Feasibility studiesYesNom. Flow sheetsYesNon. Geotechnical servicesYesNoo. Inspection of installation workYesNop. Instructions to TenderersYesNoq. Issuing variation ordersYesNor. MeasurementYesNos. Quality control and assuranceYesNot. Quantity estimatesYesNou. Settling contractual claimsYesNov. Supervision of commissioningYesNow. Tender adjudicationYesNox. Working drawingsYesNoy. Other (please elaborate)YesNoSection Break1) Please supply total numbers of Names of Partners, Principals and Directors Age Qualifications Date Qualified Period Practicing as Partner, Principal or Director This Practice Period Practising (previous Practise) Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 2) Please supply total numbers ofa) Professionally Qualified Staffa) Partners/principals/directorsb) Qualified Staffb) Other Skilled and Technical Staffc) Other technical (including para legals)c) Non-Technical(Administration) Staffc) Other technical staffsd) Construction Consultant (Other Staffs)d) Trainee staffd) Accountant (Other Staffs)e) Non-technical administrative stafff) Clerical staffg) Other staff (please specify)If "others", please specify3) Does your practice always require and obtain satisfactory references when engaging employees?YesNoAre you a Sole Proprietor?YesNo4) State the experience of your assistants and their length of service.5) What arrangements do you have to assist you during your temporary absence on business, leave, sickness, or unforseen emergency? Business Conduct1. Are there any aspects of the project (or part of the project) which:a. Do not utilise well-established tried and tested techniquesYesNob. Comprise or include prototype or innovative construction techniques, designs or materials?YesNoc. Involve the performance of professional services in regards to off-shore or sub-aqueous works?YesNod. You are unfamiliar with and/or do not fall within the scope of work with which you are experienced?YesNoe. Are unusual with regards to the performance quality, durability or tolerance required?YesNof. You consider should be brought to the insurer’s attention?YesNoIf ‘yes’ to the above, please provide detailsSection Break1) Has the name of your practice ever been changed?YesNoIf "Yes", please provide details2) Has any other practice or business amalgamated or merged with your practice?YesNoIf "Yes", please provide details3) Have you purchased any other practice or business?YesNoIf "Yes", please provide details4) Is any partner, principal or director connected or associated (financially or otherwise) with any other practice or business?YesNoIf "Yes", please provide details4) Does the practice undertake work for any firm, company or organisation in which any partner, principal or director holds a position whereby he is able to make major policy decisions on behalf of such firm, company or organisation?YesNoIf "Yes", please provide details5) Please list the professional bodies or associations to which you and/or your practice belong.5) Are you authorised by the MAS under the Financial Advisers Act to provide financial advice?YesNo6) What is your FAA LicenceDetails of Activities5.1 Do you facilitate overseas investments for local investors?YesNo5.2 Do you promote tax effective investments for expatriates or residents of Singapore with citizenship elsewhere (e.g. tax effective planning for UK Citizens working in Singapore)?YesNo5.3 Do you hold a binding authority with any insurer (including cover note books or “immediate issue” policy pads)?YesNoIf "yes", please elaborate5.4 Do you provide services to customers not resident in Singapore, or work for clients located overseas?YesNoIf "yes", please elaborateType of work doneLife Insurance SalesFinancial PlanningGeneral Insurance SalesPercentage of total revenueLife Insurance SalesEndowment Life InsuranceGlobal Health Plans (Worldwide Cover)Investment-linked Life InsuranceShield Plans (Medical or Eldershield enhancement)Term InsuranceUniversal Life InsuranceWhole Life InsuranceOthers (Please specify)If Others, Please specifyIn respect of Life Insurance activities; Please list the Life Insurance Companies you deal with: Name of company % of client policies placed Edit Delete There are no Entries. Add Entry Maximum number of entries reached. General InsuranceAccident & Health (Inc. Disability)Credit/Surety InsuranceGeneral Accident (Inc. Public Liability)Marine or AviationMotor InsurancePersonal Lines (e.g., Travel, Home)Professional LiabilityProperty (Inc. Business Packages)Worker/Employee CompensationGeneral Insurance Sales (Others)If "others", please specifyIn respect of General Insurance placements, are you licensed by MAS to place general insurance?YesNoWhat is your license number?Financial PlanningAlternative Investments (e.g., Hedge funds)Global Savings AccountsUnit Trust SalesInvestment Advice (Others)If "others", please specify2) In respect of Investment Advice: Do you promote or sell strategies that encompass:3.1.1 Investments other than cash bonds or liquid equityYesNo3.1.2 Real estate property investments other than REITs listed on SGXYesNo3.1.3 Hedging strategies for either equity or foreign exchangeYesNo3.1.4 Unit trusts not listed on the SGXYesNoIf you have answered "Yes" to any of the above, please supply details3.2 What percentage of your clients funds are placed directly with third party fund or equity asset managers3.3 Are you financially associated (either directly or indirectly) with any of the fund or equity asset managers you use?YesNoIf you have answered "Yes" to the above, please supply details3.4 Do you engage in discretionary trading on behalf of your clients?YesNoIf you have answered "Yes" to the above, please supply detailsRisk management1. Please provide details of the methods of control used to monitor and supervise the activities of your appointed representatives.2. Are staff instructed never to sign proposal forms on behalf of clients?YesNo3. Do you have set questionnaires that solicits relevant information about the clients’/ investors’ specific needs and circumstances?YesNo4. Do you have a standard letter or engagement outlining your duties and the respective clients responsibilities?YesNo5. Do you have standard disclaimers or warranties that you use/apply with all advice?YesNoIf “Yes” to Part F.3, F.4, or F.5 please provide a copy of these.6. Are all contracts reviewed by a law firm experienced in your profession?YesNoIf "No", please supply details on how you review and approve contracts7.1 In respect of investment advice or financial plans, are they individually tailored to meet the specific needs, goals and investment objectives of your respective clients?YesNo7.2 In respect of investment advice or financial plans, are they solely provided by registered advisors?YesNo7.3 In respect of investment advice or financial plans, are they counter reviewed and signed off by a financial advisory manager of the firm?YesNo8. Do you guarantee the future performance of any investment or financial plan?YesNoIf ‘yes’ to the above, please provide details9. Do you maintain a list ‘approved’ investment products and other products you promote?YesNoIf “Yes”, how are these ‘approved’ products selected and how often is the list reviewed?If “No”, how do you determine which products to promote?10. Do you engage consultants, sub-contractors or agents?YesNo10.1 If "Yes", Do you insist they carry their own professional indemnity insurance?YesNo10.2 If "yes", Do you enter into any hold-harmless agreements or otherwise waive any legal rights or entitlements which you may have against such consultants, sub-contractors or agents?YesNo6) Please detail the approximate percentage of your fees or other consulting income derived from the following fields of work:a) Commercial conveyancingb) Residential conveyancingc) Criminal litigationd) Civil litigatione) Tax, estate and trusteef) Corporate law (other than M&A)g) Mergers & acquisitionsh) Patent, trademark & copy righti) Others6) Please detail the approximate percentage of your fees or other consulting income derived from the following fields of work:a) Estate Agency (General Practise)b) Valuationc) Auctioneeringd) Rent collectione) Strata title/property managementf) Loss assessment/adjustmentg) Insurance agency/financial institutions agencyh) Property conveyancing/ settlement agency/land brokingi) Project managementj) Other (please specify)6. Please categorise your activities or business conducted and indicate the approximate percentage of your fee income derived from each activity.ai) Audit - Public Companiesaii) Audit - Private Companiesb) Accounts Preparation/ Book Keepingc) Payroll(d) Tax Advice - Public Companiesdii) Tax Advice - Private Companiesdii) Tax Advice - Individuals(e) Directorships/Secretarial Positions(f) Insolvencies, Liquidations & Receivership(g) Executorship And Trusteeship(h) Corporate Financing(i) Mergers And Acquisitions(j) Management Consulting6. Please categorise your activities or business conducted and indicate the approximate percentage of your fee income derived from each activity.ai) Consultant Engineering - Civilaii) Consultant Engineering - Structuralaiii) Consultant Engineering - Mechanicalaiv) Consultant Engineering - Electricalav) Consultant Engineering - Acousticalavi) Consultant Engineering - Geotechnical/Soil/Foundationavii) Consultant Engineering - Heating and Ventilationaviii) Consultant Engineering - Miningaix) Consultant Engineering - Nuclearax) Consultant Engineering - Environmental(b) Architecture(c) Drafting(d) Town Planningei) Surveying - Building Surveyingeii) Surveying - Land Surveyingeiii) Surveying - Quantity Surveying(f) Interior Designing(g) Project Management/Construction Management(h) Registered Inspection/Accredited CheckingSection Break5. Do you do any work or give any advice regarding investment and trading documents or related matters?YesNoIf "Yes", please provide details6. Do you do any work or give any advice to Financial Institutions?YesNoIf “Yes”, please provide the percentage of your work done for such Financial Institutions7. Do you engage consultants or sub-contractors?YesNoIf "Yes", a) do you insist they carry their own professional indemnity insurance?YesNoIf "Yes", b) do you enter into any hold-harmless agreements or otherwise waive any legal rights or entitlements which you may have against such consultants or sub-contractors?YesNo7) Have you undertaken any other activities in the past for which cover is required?YesNoIf "yes", please elaborate7) Please detail the approximate percentage of your total work in the following areas:a) Domestic propertyb) Industrial/commercial propertyc) Rural propertyd) Hotel/licensed premisese) Plant/machineryf) Other (please specify)Section Break7. Please indicate the approximate percentage of the total fees that your business derives from work where the main contract or interest is: Type of work Current Year (%) Previous Year (%) Edit Delete There are no Entries. Add Entry Maximum number of entries reached. If "yes", please elaborate8) Do you or have you done any work or given any advice to financial institutions?YesNoIf "yes", please elaborate8. Do you undertake valuations?YesNo8.1) Please detail the approximate percentage of your fee income FOR VALUATION WORK derived from the following areas:a) Domestic propertyb) Industrial/commercial propertyc) Rural propertyd) Hotel/licensed premisese) Plant/machineryf) Municipal valuationsg) Other (please specify)Section Break8. Are verbal reports always confirmed in writing?YesNoIf “No”, how do you substantiate such verbal reports?8. Have you undertaken any other activities in the past for which cover is required?YesNoIf "Yes", please provide details9. Do you perform work outside of Singapore, or work for clients located overseas?YesNoIf “Yes”, please supply locations and details of work.9) Are valuations only undertaken by professionally qualified and/or licensed valuers?YesNoIf “No”, please supply details.9) Do all instruments issued for the operation of bank account(s) bear at least two signatures where the amount of such instrument exceeds $10,000?YesNoIf “No”, what checks do you have in place?9. Does your practice have a system in place for ensuring that time limits and critical dates are met?YesNoIf “No”, how do you keep track of such time limits and critical dates?10. Do you envisage any substantial changes in your activities, or are there any major new operations contemplated during the next 12 months?YesNoIf “Yes”, please supply details.10) Does your practice have a system in place for ensuring that time limits and critical dates are met?YesNoIf “No”, how do you keep track of such time limits and critical dates?10) Do you provide strata title management?YesNoIf "yes", please provide the approximate number of blocks managed during the last 12 months10. Please provide a brief description and fees of the five (5) largest contracts(in terms of contract value) undertaken over the past five (5) years: Client Brief Description Type of work Fees Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 11.1) Please state the number of agencies with binding authorities11.2) Please state the number of agencies without binding authorities11.3) Please state the percentage of total premium written for a) property or business packages11.4) Please state the percentage of total premium written for b) liability11.5) Please state the percentage of total premium written for c) Other Classes11. Do you engage consultants, sub-contractors or agents?YesNo11) Do you have a standard letter of engagement outlining your duties and the respective clients’ responsibilitiesYesNo12) Do you have a standard disclaimers or warranties that you use/apply with all advice?YesNoIf you have answered “No” to either C11 or C12, how do you outline your duties and responsibilities to the client?12) Please provide brief description, location, type and fees for the five (5) largest contracts undertaken over the past five (5) years Brief description Location Type (Industrial/Commercial Valuation etc) Fees Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 12. What percentage of your work is subcontracted out?13) Please provide a brief description and fees of the five (5) largest contracts(in terms of contract value) undertaken over the past five (5) years: Client Brief Description Type of work Fees Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 13) Does any contract or client represent more than 50% of your annual work or fees?YesNoIf "yes", please elaborate13. What is the nature of the work undertaken by them?14) Do you engage consultants, sub-contractors or agents (other than real estate agents)?YesNo14) Do you engage consultants, sub-contractors or agents?YesNo14.1) If "yes" , do you insist they carry their own professional indemnity insurance?YesNo14.2) If 'Yes", do you enter into any hold-harmless agreements or otherwise waive any legal rights or entitlements which you may have against such consultants, sub-contractors or agents?YesNo14) Do you perform work outside of Singapore, or work for clients located overseas?YesNoIf “Yes”, please supply locations and details of work.15. What percentage of your work is subcontracted out?15) Do you envisage any substantial changes in your activities, or are there any major new operations contemplated during the next 12 months?YesNoIf "Yes", please provide details16) What is the nature of the work undertaken by them?16) Are verbal reports always confirmed in writing?YesNoIf “No”, how do you substantiate such verbal reports?17) Do you perform work outside of Singapore, or work for clients located overseas?YesNoIf “Yes”, please supply locations and details of work.18) Do you envisage any substantial changes in your activities, or are there any major new operations contemplated during the next 12 months?YesNoIf "Yes", please provide details Financial Position of the Corporation1. Please advise the date of your financial year end 2. Please provide the amount of gross income/fees for the followingA) Period - Estimated Coming yearSingaporeOthersB) Period - Estimated Current yearSingaporeOthersC) Period - Last yearSingaporeOthers3. Please provide the amount of the largest annual fee for any one client3. Please provide the amount of the largest annual fee for any one client and supply details of contract/work.4. Please provide the approximate percentage of your activities (based on fee income) applicable to each country/region from which you derive a portion of your income.SingaporeAsiaEuropeUSA/CanadaOthers Claims History1) Has any partner, principal, director or staff member ever been subject to disciplinary proceedings for professional misconduct?YesNoIf “Yes”, please supply details.2) Have any claims for negligence or breach of professional duty been made in the last ten (10) years against your practice or any of its predecessors in business or any prior practice of any of your practice’s present or former partners, principals or directors, or have circumstances been notified to insurers that might give rise to a claim?YesNoIf “Yes”, please provide the following details in respect of each matter on your company’s letterhead and attach:• Date of Claim made • Name of Insurer (if any) • Name of Claimant or Potential Claimant • Brief description of matter and latest update • Amounts (If any) of claim paid and estimated outstanding amounts • Is matter finalised or outstanding and when was the last update? • What actions have been undertaken to prevent a recurrence of the situation which gave rise to each claim?Accepted file types: jpg, jpeg, pdf, png, doc, docx.If "Yes", please supply details Date Matter Notified Insurer Name Claiment Name (Potential/Actual) Brief Description of Matter Amount Paid or Estimate of Potential Liability Is the Matter finalised or o/s? Edit Delete There are no Entries. Add Entry Maximum number of entries reached. 3. Are there any circumstances not already notified to Insurers which may give rise to a claim against you?YesNoIf “Yes”, please provide the following details in respect of each matter on your company’s letterhead and attach• Name of Claimant or Potential Claimant • Brief Description of Matter • Estimate of Potential LiabilityAccepted file types: jpg, jpeg, pdf, png, doc, docx.3) Are any of the partners, principals or directors, AFTER ENQUIRY, aware of any claim or circumstances that might give rise to a claim against your practice or any prior practice or any of their present or former partners, principals or directors which matter is not referred to in question F.2 above?YesNoIf "Yes", please provide the following details in respect to each matter. Claiment Name (Potential/Actual) Brief Description of Matter Estimate of Potential Liability Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Insurance Cover1. Limit of indemnity required:2. Deductible/Excess requested (Each and every Claim):Period of Insurance (From) Period of Insurance (To) 1. Does your practice presently carry, or has your practice ever carried, professional indemnity insurance?YesNoIf “Yes”, please supply details:InsurerExpiry Date Limit of IndemnityDeductibleSection Break2. Has your practice or any partner, principal or director ever been refused this type of insurance, or had similar insurance cancelled, or had an application of renewal declined, or had special terms imposed?YesNoIf “Yes”, please supply details.Application For Cover1. Limit of indemnity required:2. Deductible/Excess requested (Each and every Claim):3) Extensionsi) Automatic Extensions • Libel and slander Automatically Included • Loss of documents Automatically Included • Consultants, subcontractors and agents Automatically Included • Intellectual property Automatically Included • Joint venture liability Automatically Included • Newly created or acquired entity or subsidiary Automatically Included • Run-off cover insured entity or subsidiary Automatically Included • Estates and legal representatives Automatically Included • Outgoing principals Automatically Included ii) Please indicate if you seek cover for the following optional extension.Fraud and dishonestyPrevious business
