Customer Declaration: I certify that

1. I have read and accept the Service Agreement of this contract and the disclaimer and I apply for indemnity under my chosen Contract.
2. I understand and accept that:
   - if the provider does not receive the proposal form and the premium, this contract will not be valid.
   - a contract will only be formed when I receive the Validation Form; and
   - if I have not received a Laidation Form within 60 days, I should contact the provideron 0870 849 9811.
3. I understand that the Provider's obligations apply for the period of cover stated on the Proposal Form and begin from the date of purchase and at the mileage on that date.
4. I understand that the Contract cannot be changed once the Provider has accepted this Proposal Form.
5. I understand that the personal data I have submitted will be used by London General Holdings Ltd. for the purpose of my contract and a copy of my data is available to me upon request and payment of a fee.

Servicing Intervals:
6,000 miles / 6 months (full service history is not available)

Manufacturer recommended intervals (full service history is available)

Servicing Intervals: If the vehicle I have purchased has a service book with full service history I agree to continue to service the vehicle in accordance with the manufacturers recommandations for my particular make, type and age of vehicle.
If no such evidence of service is present I agree to service the vihicle at intervals of 6 months or 6,000 miles (whichever is sooner) from the date of purchase.
I understand that if I do not comply with these servicing requirements I will invalidate the protection provided under this Service Contract.