Important Notice:

The Applicant is hereby notified that by virtue of accepting these terms and conditions, it is hereby understood and agreed that these terms and conditions shall be deemed binding and legally enforceable in a court of law and shall have the same legal effects as that of a signed agreement between the Applicant and Etiqa Insurance Pte. Ltd.

I/We hereby declare that the answers and statements given in the Application are true and complete, and that I/We have not withheld any material information.

This Proposal and any Guarantee issued pursuant to this Proposal shall be subject to the Counter-Indemnity set forth below, to which terms and conditions I/We agree.

In consideration of Etiqa Insurance Pte. Ltd. ('the Insurer') agreeing at my/our request to issue:

• a.A Letter of Guarantee for the sum of Singapore Dollars Five Thousand Only
  (S$5, 000) to the Ministry of Manpower, Singapore as security for the duty and satisfactory observance and performance of all conditionals under the Security Bond and/or
  

• b.(If applicable) a Letter of Guarantee for the sum of Singapore Dollars Seven Thousand only (S$7, 000) to the Labor Attached (the Labatt), Embassy of the Philippines in Singapore for Compliance of the Standard Employment contract for Filipino Household Workers in Singapore.

I/We hereby jointly and severally, irrevocably and unconditionally agree and undertake for myself/ourselves and my/our heirs, executors, administrators, assigns and successors that:

1. As a continuing obligation I/We shall indemnify and keep indemnified the Insurer from and against all claims, demands, payments, actions, suits, proceedings, losses, expenses including legal costs on an indemnity basis and all other liabilities of whatsoever nature or description which may be or taken against or incurred by the Insurer in relation to or arising out of the Guarantee and/or this Counter-Indemnity.
   

2. Where any request is made upon the Insurer by the Controller for payment of any sum of money pursuant to the Guarantee ('such request'), the Insurer shall at its absolute discretion be at liberty to contest or compromise or immediately pay upon such request and such request shall be sufficient authority to the Insurer for making any payment thereon without requiring or obtaining any evidence or proof that the amount so claimed or requested is due payable to the Controller and without any notice or reference to or further authority from me/us notwithstanding that I/We may dispute the validity at any such claim or request.

3. I/We shall not at any time question or challenge the validity, legality or otherwise of any payment made by the Insurer to the Controller pursuant to such request or deny any liability under this Counter-Indemnity on the ground that such payment or any part thereof made by the Insurer was not due or payable under the Guarantee or on any other ground whatsoever.

4. I/We shall not be discharged or released from the Indemnity by any compromise, variation or arrangement made between the Controller and the Insurer in relation to the obligations undertaken by the Insurer under the Guarantee or by any forbearance whether as to payment, time, performance or otherwise given by the Controller to the Insurer.

5. My/Our liability herein is irrevocable and shall remain in full force and effect until the Insurer’s liability under the Guarantee is fully discharged to the Insurer’s satisfaction.

6. This indemnity shall be governed by and construed in accordance with the laws of Singapore.

I/We confirm

(a) that the above particulars to be true and correct and I/We agree that they shall be the basis of the contract between the Company and myself/ourselves.

(b) my/our agreement on behalf of myself/ourselves and any person(s), firm or corporation, that any information collected or held by the Company (whether contained in this Application or otherwise obtained) may be used and disclosed by the Company, its associated individuals/companies or any independent third parties (within or outside Singapore for any matters relating to this Application, any policy issued in relation thereto and to communicate solely for this purpose.

I/We expressly authorise and consent to Etiqa Insurance Pte Ltd. ("Etiqa"), its officers and employees, at their sole discretion, to disclose any and all information relating to me/us, including my/our personal particulars, my/our transactions and dealings and my/our policies of insurance with Etiqa, to any of the following persons, whether in Singapore or elsewhere, for purposes reasonably required to evaluate my/our application and to provide the product or services which I/we am/are applying for (including any new policy application, renewals and/or alterations), for such persons to market relevant products/services and such other purposes as described in Etiqa's Data Protection and Privacy Statement on Etiqa's website:

• Etiqa's holding company, subsidiary, branches, representative officers, related corporations or affiliates;
• any of Etiqa's contractors or third party service providers or distribution partners or professional advisers or representative;
• any regulatory, supervisory or other authority, court of law, tribunal or person, in any jurisdiction, where such disclosure is required by law, regulation, judgement or order of court or order of any tribunal or as a matter of practice;
• any actual or potential assignee(s) or transferee(s) of any rights and obligations of Etiqa under or relating to my policy or policies for any purpose connected with the proposed assignment or transfer;
• any credit bureau or insurer, for such purpose(s) that Etiqa in its reasonable opinion considers appropriate including but not limited to the purposes of underwriting, customer servicing and investigation;
• any business partners, third party referrers, broker, introducer or other intermediary; and
• any other party to whom you have consented the disclosure of your Personal Data

By providing the information, I/We consent to Etiqa and its related, its agents, authorised service providers and marketing partners collecting, using or disclosing and/or processing my/our personal data, for the purpose to evaluate my/our proposal form and to provide the product and services which I/We am applying for and such other purposes as stated in Etiqa's Data Protection Statement on Etiqa's website, which I/We confirmed that I/We have read and understood.

I/We confirm and agree that my/our consents herein supplement but do not supersede or replace any other consents which I/We may have previously provided to Etiqa, and are additional to any rights which Etiqa may have at law to collect, use or disclose my personal data, with or without my/ our consent, to the extent permitted under applicable law.

In addition, where personal data of any person is disclosed by me/us, I/ We further confirm and represent that I/ We have obtained the consent of the individual concerned for the purposes, unless such consent is not required under applicable laws.

• All information provided by me in connection with this application are true, accurate and complete
• I agree that this application and declaration shall be the basis of the contract between Etiqa and myself
• If I do not fully and faithfully give the facts as I know them or ought to know them, I may receive nothing from the policy
• I agree to the policy terms, exclusions and conditions as expressed in the proposal form, policy wordings and endorsements

• I have been duly authorised by the Applicant to act on his/ her/ their behalf for the purpose of applying for this insurance.
• I confirm that I have read, informed and explained to the Applicant on the Policy Wordings, Application Summary, and Data Protection Statement. The Applicant understood and has agreed to it.
• I also confirm that the Applicant has read and acknowledged the “Applicant’s Consent and Declaration” section. I confirm I have duly obtained and retained the copy of the Applicant’s acknowledgement of the “Applicant’s Consent and Declaration” section. I will provide any necessary documentation as and when required by Etiqa or as mandated by applicable laws and regulations.
• I confirm that all information provided in this Application and supporting document (where applicable) is accurate, true and complete to the best of my knowledge.
• I declare that there is no conflict of interest in the arrangement of this insurance policy.
• I agree to the policy terms, exclusions and conditions as expressed in the proposal form, policy wordings and endorsements