Business Design Centre
52 Upper Street
Islington
London
N1 0QH

t: (44) 020 7288 6003
F: (44) 020 7288 6004
e: info@briffa.com

Sign-up for DesignProtect Insurance

You can email us using this form to request DesignProtect Insurance.  By ‘you’ or ‘your’ we mean the person to be insured who is the person who owns the copyright to be protected whether that is an individual or company – by your putting a company name in field 2 we will assume it belongs to the Company.

Contact Name:
Business Name:
Position in business:
Type of Business:
Address 1:
Address 2:
Town/City:
County:
Postcode:
Telephone:
Mobile:
Fax:
Email:
What is your annual turnover?	-- Please select -- £0-50,000 £50,001-100,000 £100,001-250,000 £250,001-500,000 £500,001 +
Are you a citizen of or ordinarily resident in the UK or a company incorporated in the UK?	Yes No
Does the insured (you or your company) have any other insurance that might protect you in relation to legal actions (consider the terms of any general household and/or credit card insurance you might have and, if you believe you do or even might, please provide copies).	Yes No
Are you aware of any existing infringements of your copyright or designs?:	Yes No
Tell us anything else you think is relevant:

We understand that you own works and require insurance in relation to civil legal actions in the UK (other than against a co-owner) for infringement relating to copyright and design rights in those works.  Provided you have acted reasonably DesignProtect Insurance will provide insurance against such risk of up to 90% of your legal expenses up to the relevant limit of indemnity specified.

On submission of this form we will send you a welcome pack which includes details of the insurance together with terms and conditions and our invoice for the premium. Your insurance protection commences on submission of copies of your copyright/designs to our offices together with payment of our invoice and only covers copies of those items submitted from the time the premium is paid. On payment of our invoice you thereby agree to the terms and conditions of the insurance policy as set out in the welcome pack.

If upon receipt of the Welcome Pack you for any reason change your mind you have a right to cancellation before our invoice is paid in full. Please email designprotect@briffa.com.

BRIFFA
Intellectual Property and Information Technology Lawyers