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CompuOffice Software Inc.

8300 Woodbine Ave suite 200

Markham, Ontario, Canada L3R 9Y7

Tel: (905) 475-7500	Fax: (905) 475-7599
E-Mail:colg@compuoffice.com	Web Site:http://www.compuoffice.com
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Single Agent Declaration

I, hereby declare as follows:

I am a duly licensed life insurance agent, authorized to offer life insurance to the public.
I hereby declare that I have been notified and am fully aware that any and all figures and premium prices produced by CompuOffice Software Inc. are intended for initial educational and guidance purposes only and are not guarantees of any nature whatsoever.
I hereby declare that I am fully responsible for any and all figures and any and all content, including narrative and graphic content that will be shown on my web-site and that I hereby release and shall hold harmless CompuOffice Software Inc., its employees, shareholders and contractors from any responsibility whatsoever for any content, including figures and premium prices shown, displayed or accessed at my website.
I hereby declare that I am adequately insured by a currently in-force Errors and Omissions insurance policy.
I hereby delare that I shall provide service to the public in a professional manner that shall at least meet the standard that is expected by regulators and my Errors and Omissions insurance carrier(s). In dealing with the public, including my representations at my website, I shall regard the best interest of the consumer as the first and most important objective.
I recognize that the service provided to me by CompuOffice Software Inc. includes intellectual property that is the property of CompuOffice Software Inc. and shall not permit any other person or entity to use such in any manner other than as licensed to me for provision to visitors to my website. In this regard, I understand that the services provided to me by CompuOffice Software Inc. or access thereto, may not be copied or re-sold to another person or entity and that I shall be held fully responsible for all fees and costs should such occur with my knowledge or consent or through negligence on my part or on part of any person or entity acting on my behalf.
BY CHECKING THE BOX "I UNDERSTAND AND AGREE" AND BY INSERTING MY E-MAIL ADDRESS, I HEREBY RE-CONFIRM THAT I HAVE READ AND FULLY UNDERSTOOD THE ENTIRETY OF THE "SINGLE AGENT DECLARATION"

I AGREE. TO RE-CONFIRM MY AGREEMENT, I AM ENTERING MY E-MAIL ADDRESS

MGA Agent Declaration

On behalf of , I hereby declare as follows:

I am a duly authorized signing officer, authorized to sign on behalf of .
I hereby declare that, as a duly authorized representative of I have been notified and am fully aware that any and all figures and premium prices produced by CompuOffice Software Inc. are intended for initial educational and guidance purposes only and are not guarantees of any nature whatsoever.
I hereby declare that we will be fully responsible for any and all figures and any and all content, including narrative and graphic content that will be shown on our web-site and that we hereby release and shall hold harmless CompuOffice Software Inc., its employees, shareholders and contractors from any responsibility whatsoever for any content, including figures and premium prices shown, displayed or accessed at our website.
I hereby declare that we are adequately insured by a currently in-force Errors and Omissions insurance policy.
I hereby delare that our services to agents, brokers and/or the public are fully our responsibility. In the event that we provide any service direct tot he public, we shall provide service to the public in a professional manner that shall at least meet the standard that is expected by regulators and my Errors and Omissions insurance carrier(s). In dealing with the public, including our representations at our website, we shall regard the best interest of the consumer as the first and most important objective.
I recognize that the service provided to us by CompuOffice Software Inc. includes intellectual property that is the property of CompuOffice Software Inc. and we shall not permit any other person or entity to use such in any manner other than as licensed to us in our capacity as a Managing General Agency (MGA) for provision to visitors to our website. In this regard, I understand that the services provided to us by CompuOffice Software Inc. or access to such services, may not be copied or re-sold to another person or entity and that we shall be held fully responsible for all fees and costs should such occur with our knowledge or consent or through negligence on my part or on part of any person or entity, including independent contractors, acting on our behalf.
BY CHECKING THE BOX "I UNDERSTAND AND AGREE" AND BY INSERTING MY E-MAIL ADDRESS, I HEREBY RE-CONFIRM THAT I HAVE READ AND FULLY UNDERSTOOD THE ENTIRETY OF THE MGA DECLARATION"

I AGREE. TO RE-CONFIRM MY AGREEMENT, I AM ENTERING MY E-MAIL ADDRESS