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Rep & Warranty Insurance
Please fill out this form so that your Rep & Warranty Insurance expert is best prepared to help you.
Step
1
of
2
50%
Name
First
Last
Phone
Email
What Type of Policy Will You Need?
(Required)
Buy-Side
Sell-Side
Please select one option
Has the Bidder Reached Exclusivity?
(Required)
Yes
No
Please select one option
Expected Signing Date:
(Required)
MM slash DD slash YYYY
Expected Closing Date:
(Required)
MM slash DD slash YYYY
Purchase Price/Enterprise Value:
(Required)
Escrow Terms:
(Required)
Dollar amount/time period (i.e. 10%/$3,000,000/24 months)
Name of Seller:
(Required)
Type of Seller:
(Required)
Founder
Private Group
Family Office
Private Equity
Please select one option
Brief Description of Target Entity:
(Required)
Seller’s Counsel:
Name of Buyer:
(Required)
Type of Buyer:
(Required)
Strategic
Financial
Private Equity
Please select one option
Brief Description of Buyer:
(Required)
Buyer’s Counsel:
Please be prepared to provide the following documents once you connect with your expert.
Confidential Information Memorandum (CIM) or similar document (e.g. management presentation, etc.)
Financial Statements of the Target Entity
Quality of Earnings
The Purchase and Sale Agreement
Please select the documents you will be providing.
What 3rd Party and/or Internal Due Diligence Has Been or Is Expected to Be Performed?
(Required)
Pleaser provide a brief description.
