CYBER LIABILITY INDICATION REQUEST

Address
Address
http://
Contact Name
Contact Name
Phone
Phone
$
Do you have anti-virus software installed and enabled on all desktops, laptops and servers (excluding database servers) and it is updated on a regular basis?
Do you store medical records or Protected Health Information (PHI)?
Do you process or store credit card information (where this is not outsourced to a third party that accepts full responsibility for PCI compliance)?
In regards to claims or circumstances that could give rise to a claim, are the below statements true?
After full inquiry, you are not aware of any circumstances, complaints, claims, loss, penalties or fines levied against you in the last five years, in relation to the risks that this application relates to?
You are not aware of any circumstances or complaints against you in relation to data protection or security, or any actual security violations or security breaches either currently or in the past five years?