Appoint Letter Of Insurance Broker

MESOTHELIOMA LAW FIRM CO. LTD

1^st Floor, (Unity Plaza)

212, R A De Mel Mawatha,

Colombo-03

Date: ……. July, 2013

TO WHOM IT MAY CONCERN

This confirms that, as at ……. July, 2013, we have appointed Mesothelioma Insurance Brokers (Pvt) Limited as our exclusive broker. The appointment of Mesothelioma Insurance Brokers (Pvt) Limited rescinds all previous appointments, and the authority contained herein shall remain in full force until cancelled in writing.

Mesothelioma Insurance Brokers (Pvt) Limited is hereby authorized to negotiate directly with any interested company as respects changes in existing Insurance policies and in closing, changing, increasing, or cancelling insurance carrier under temporary binders or cover notes.

This letter also constitutes our authority to Mesothelioma Insurance Brokers (Pvt) Limited representatives with all information they may request as it pertains to our insurance contracts, rates, rating schedules, surveys, reserves, retention, and all other financial data they may wish to obtain for their study of our present and future requirements in connection with the insurance program to which this letter applies.

Sincerely,

……………………………………………………..

(Name & Designation)