Important notices:
1. This Insurance is underwritten by HDI Global Specialty SE - Australia, (ABN 58 129 395 544, AFS Licence number 458776), with its registered
address at Tower 1, Level 33, 100 Barangaroo Avenue, Sydney NSW, 2000. Telephone (02) 8373 7580.
2. One Underwriting acts as an agent of HDI Global Specialty SE - Australia in arranging and entering into this motor insurance, not the Insured.
3. This quotation is valid only for a period of thirty (30) days and may be withdrawn or varied at any time by Us.
4. By submitting the request for quotation You confirm that You have read and agree to the terms of the Privacy Notice and Terms of Business sent
to You by Us.
5. In submitting this information You are acting as agent of the proposed insured(s) and are doing so on their behalf.

Our Product Disclosure Statement:
The law requires that we make available our Target Market Determination (TMD) and that you receive a “Product Disclosure Statement” (PDS)
prepared by HDI Global Specialty SE - Australia. The PDS aims to give You enough information to decide whether to buy this product. The PDS
is made up of a number of documents. The Proposal (or electronic declaration) and the PDS and Policy Wording contains the standard terms
and conditions of cover. If cover is issued, the Policy Schedule other documents We tell You are included, will update and becomes part of
the PDS. These documents are available to You (if You or Your agent does not already have them, by calling Us, visiting our office or website:
oneunderwriting.com.au)

Your Duty of Disclosure:
Before You enter into a contract of insurance, You generally have a duty under the Insurance Contracts Act 1984 (Cth) (ICA) to disclose anything that
You know, or could reasonably be expected to know, or in the case of consumer contracts (as defined in Part IV of the ICA) (Consumer Contracts) to
take all reasonable care to disclose anything that You know, or could reasonably be expected to know, that may affect the insurer’s decision to insure
You and on what terms. This includes Your driving record and insurance history for the previous five (5) years and any criminal convictions whether
current or spent for the previous ten (10) years prior to the inception of, or renewal of the insurance Policy.
You have that duty after proposal, and up until the time the insurer agrees to insure You. You have the same duty before You renew, extend, vary or
reinstate a contract of insurance.

You do not need to tell the insurer anything that:
• reduces the risk that is insured;
• is common knowledge;
• Your insurer knows or should know as an insurer; or
• the insurer waives compliance with Your duty of disclosure.
If You are uncertain about whether or not a particular matter should be disclosed to the insurer, please refer to any guidance issued in any insurance
proposal or application form, Your Duty of Disclosure obligations contained in any PDS and Policy terms and conditions (as applicable) and contact
Your appointed insurance broker or Us.

Non Disclosure:
If You fail to take reasonable care in disclosing information to us in the case of Consumer Contracts, or do not tell Your insurer anything You are
required to, the insurer may cancel Your contract or reduce the amount that it is required to pay You if You make a claim, or both. If Your failure to
disclose is fraudulent, the insurer may refuse to pay a claim and treat the contract as if it never existed.

Short Form Privacy Disclosure and Consent
Application/Claim Forms
1. One Underwriting Pty Ltd is committed to protecting Your personal information in accordance with the Australian Privacy Principles under
the Privacy Act 1988 (Cth). We collect, use and disclose personal information to offer, promote, provide, manage and administer our various
insurance services We are involved in as set out in the One Underwriting Privacy Notice. In order to do this, We may also share your information
with other persons or entities who assist Us in providing or promoting our services as set out in the One Underwriting Privacy Notice. Further
information about our privacy practices can be located in the One Underwriting Privacy Policy, a copy of which can also be sent to You on
request by Your One Underwriting representative. You may also gain access to Your personal information, or modify Your privacy preferences,
by contacting Your One Underwriting representative or our Privacy Officer through the means set out in the One Underwriting Privacy Notice.
2. If You are disclosing personal or sensitive information about any other person to One Underwriting, You confirm that You have obtained
the consent of that person to disclose to One Underwriting their personal or sensitive information and You have made them aware that One
Underwriting will or may disclose their information to third parties that are reasonably necessary to assist in the provision of the relevant services
or products. If You have not obtained consent from this other person to disclose their personal or sensitive information to One Underwriting,
You will inform Us before providing the relevant information to Us.
By submitting this Quotation & Proposal Securus Motor Insurance, You acknowledge that You have read the One Underwriting Privacy Notice and
agree that We can handle any personal information You have provided to Us in the manner set out above.

Declaration
I/We agree on my own behalf and on behalf of all other insured persons that: the within statements are true. The Duty of Disclosure has been
complied with. The Vehicle described is and shall be maintained in an appropriate condition. When signing the Proposal/Quotation Form, I/We
acknowledge that should some or all of the answers stated in this form NOT be in my/our own handwriting, the answers have been checked and
I/We certify they are correct and that I/We agree to accept a policy subject to the terms, exceptions and conditions prescribed therein. The Vehicle
to be Insured shall not be driven by any person other than an Authorised Driver or an Excepted Person or as otherwise endorsed to Your Policy
Schedule. The Vehicle to be Insured shall not be driven by any person who to my/our knowledge has been refused any motor insurance or the
continuance thereof. The Product Disclosure Statement (PDS) for this policy may be made available as described in the “Our Product Disclosure
Statement’ notice. I/We have read and agree to the terms of the Privacy Notice.