1. Understand the terms of this coverage and acknowledge receipt of a sample copy of the policy (Evidence of Insurance). Please pay special attention to #3(b) as it pertains to packaging.
2. Agree to pay each month's insurance premium before the 10th of the following month.
3. Will correctly report all parcels shipped by the carrier(s) during the period of this coverage, and agree that Underwriter reserves the right to audit all reports.
4. Understand that this policy does not cover a carrier's automatic coverage, if any.
5. Certify that the information I have provided to compute my rate of premium was accurate and complete.
6. Understand that I must keep a declared value report to be sent in with my premium check monthly.
7. When using the USPS for shipping, I agree to submit all claims within 90 days of shipment date or my claims will be denied.

By signing below, you irrevocably agree to all of the terms and conditions of this agreement. Please note, your acceptance of and compliance with the terms and conditions of this agreement are a condition of your right to use U-PIC provided package insurance. Using U-PIC provided package insurance affirms your acceptance of this agreement and all terms and conditions.

Any person who knowingly and with intent to defraud any insurance company or other persons, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, which is a crime, subject to criminal prosecution and civil penalties.

Sign & fax to (818)971-3329
or mail to: U-PIC Insurance Services
                 28001 Dorothy Dr, 2nd floor
                 Agoura Hills, CA 91301