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<br />Proposal of Insurance For Naveed Haider, M.D. <br />Page 6 of 16 <br /> <br />Bindable Quotations, Marketing Highlights & Compensation Disclosure Schedule <br />Obtaining a comprehensive and competitively priced program of insurance in the marketplace requires more than access to the market. Past experience and credibility with <br />markets are the foundation of a successful campaign for your company. Complete and accurate submissions, with detailed specifications, are essential. Arthur J. Gallagher <br />Risk Management Services made a complete and personal presentation to each company contacted. <br /> <br /> <br /> <br />Some carriers pay Gallagher supplemental or contingent commissions in addition to the policy commission. Contingent commissions are typically contingent upon <br />performance factors such as growth, profit, volume or retention, while supplemental commissions are not. These supplemental or contingent commissions may range from <br />less than 1% up to 10 % of the policy premium. Please refer to the Contingent and Supplemental Commission Disclosure or contact your Gallagher representative for <br />additional information. <br /> <br />1. We were able to obtain more advantageous terms and conditions for you through an intermediary/wholesaler. <br />2. If the premium is shown as an indication: The premium indicated is an estimate provided by the market. The actual premium and acceptance of the coverage requested <br />will be determined by the market after a thorough review of the completed application. <br />*A verbal quotation was received from this carrier. We are awaiting a quotation in writing. <br />3. The commission rate is a percentage of annual premium excluding taxes & fees. <br />*Gallagher is receiving ___% commission on this policy. The fee due Gallagher will be reduced by the amount of the commissions received. <br />4. *The non-Gallagher intermediary/wholesaler did not provide their compensation information for this proposal. The usual and customary compensation to a <br />wholesaler/intermediary ranges from 5% to 12%, but we cannot verify that range is applicable in connection with this proposal. <br />Line Carrier Name Wholesaler, MGA or <br />Intermediary Name <br />(1) <br />Estimated <br />Annual <br />Premium (2) <br />"Comm % or <br />Fee <br />(3)" <br />Wholesaler, <br />MGA or <br />Intermediary % <br />(4) <br />Fee AJG <br />Owned? <br />Medical Malpractice Kinsale Insurance Company Healthcare Professional Services, <br />Inc. <br />$5,000.00 10.0% See below #4 $0 No