Name of Company* Head Office AddressBranches & AddressesTotal Number of Staff Year of Incorporation NCRIB Number* Name of Chief Executive Officer Age Date of Appointment & Status FCIB/ACIB NO TEL GSM Numbers of CEO* Email Address* Name of Chairman Line of Business i.e. General, Life, ReinsuranceDo you have outstanding claims with underwriters?* Yes No Provide details in a log formatDo you have any outstanding issue with the council / secretariat? Yes No Provide DetailsWhat is the limit of your Professional Indemnity Cover PROFESSIONAL INDEMNITY POLICYMax. file size: 64 MB.PLEASE ATTACH COPY OF YOUR CURRENT PROFESSIONAL INDEMNITY POLICY OR RENEWAL ENDORSEMENT THAT COVERS THE YEAR OF THE CERTIFICATE BEING ISSUED.NCRIB CERTIFICATEMax. file size: 64 MB.PLEASE ATTACH COPY OF YOUR LAST NCRIB CERTIFICATE AND COPY NAICOM LICENCEWhat is your current working capital? Audited AccountMax. file size: 64 MB.PLEASE ATTACH COPY OF YOUR 2018/19 AUDITED ACCOUNT.CEO's Consent* I approve all the information submittedI ATTEST THAT ALL INFORMATION GIVEN ABOVE ARE CORRECT TO THE BEST OF MY KNOWLEDGE.
