Date
I hereby agree to the terms and conditions set out in this contract (see overleaf) and agree that all information supplied to me is strictly confidential and is not to be divulged to any third party without the express permission of Valiant & Stone. I have reviewed the terms and conditions (overleaf) and I agree to those terms and conditions. I hereby confirm that I am an officer of the company/organisation duly authorised to sign this agreement on behalf of the company/ organisation that these terms and conditions shall be binding upon it. By signing this agreement, I hereby authorise the accountants stated above to provide any relevant information pertaining to the claim to be provided directly to Valiant & Stone
