User ID Information
Your password must be 8-15 characters long and contain each of the following:
At least one upper case character
At least one lower case character
At least one number
At least one special character ( for example $, %, #, @ or &)
Your password will expire every 90 days; you will be required to change your password on or before that time.
New passwords may not be the same as the previous 5 passwords.
Type of Company
- Select -
Agency / Network / Division
Post Production Company
- Select -
Antigua and Barbuda
Ashmore and Cartier Islands
Australian Antarctic Territory
Bosnia and Herzegovina
British Antarctic Territory
British Indian Ocean Territory
British Sovereign Base Areas
British Virgin Islands
Central African Republic
China, People''s Republic of
China, Republic of (Taiwan)
Cocos (Keeling) Islands
Congo, Democratic Republic of the (Congo – Kinshasa)
Congo, Republic of the (Congo – Brazzaville)
Coral Sea Islands
Cote d''Ivoire (Ivory Coast)
Falkland Islands (Islas Malvinas)
French Southern and Antarctic Lands
Heard Island and McDonald Islands
Isle of Man
Northern Mariana Islands
Palestinian Territories (Gaza Strip and West Bank)
Papua New Guinea
Peter I Island
Queen Maud Land
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
South Georgia and the South Sandwich Islands
Timor-Leste (East Timor)
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
U.S. Virgin Islands
USA and other countries
United Arab Emirates
Wallis and Futuna
- Select -
DISTRICT OF COLUMBIA
FEDERATED STATES OF MICRONESIA
NORTHERN MARIANA ISLANDS
Non US State
What company are you doing a production for (if applicable)?
Aon E-sign Disclosure and Consent to Electronic Communications
If your program requires you to complete an E&O application, you must consent to allow the E&O application to be signed electronically. If you choose not to consent, you will not be able to complete the declaration application.
Please read this document carefully and print a copy for your reference. You may refer back to it at any time by returning to this page.
Aon E-Sign Disclosure and Consent
This E-Sign Disclosure and Consent ("Disclosure"), applies to all Communications for those products and services offered through the Aon/Albert G. Ruben Insurance Services. Inc. Online Forms website that are not otherwise governed by the terms and conditions of an electronic disclosure and consent.
As used in this document, the following terms are defined:
," and "
" - refer to the Aon/Albert G. Ruben Insurance Services, Inc. entity with whom you have your Account and includes any affiliate, agent, independent contractor, designee, or assignee that we may, at our sole discretion, involve in the provisioning of your Account.
" and "
" - refer to the individual(s) or entity identified on the Account(s).
" - refers to the formal brokerage, or business relationship You established with Us to provide for regular services, and dealings usually referenced as the Wrap-up program.
" - refers to the Aon/Albert G Ruben Insurance Services Inc. Online Forms website.
" means any customer agreements or subsequent amendments, disclosures, notices, responses to claims, transaction history, privacy policies or statements and all other information related to the product or service, including but not limited to information that we are required by law to provide to you in writing.
1. Scope of Communications to Be Provided in Electronic Form.
When you use a product or service to which this Disclosure applies, you agree that we may provide you with any Communications in electronic format, and that we may discontinue sending paper Communications to you, unless and until you withdraw your consent as described in section 3 below. Your consent to receive electronic communications and transactions includes, but is not limited to:
• All legal and regulatory disclosures and communications associated with the product or service available through the AGRONLINEFORMS.
• Notices or disclosures about a change in the terms of your Account and responses to claims.
• Privacy policies and notices.
2. Method of Providing Communications to You in Electronic Form.
All Communications that we provide to you in electronic form will be provided either (1) via e-mail to an address supplied by you, (2) by access to a web site that we will designate in an e-mail notice we send to you at the time the information is available, or (3) to the extent permissible by law, by access to a web site that we will generally designate in advance for such purpose.
3. How to Withdraw Consent.
You may withdraw your consent to receive Communications in electronic form by contacting us at
212 627 7400
. At our option, we may treat your provision of an invalid email address, or the subsequent malfunction of a previously valid email address, as a withdrawal of your consent to receive electronic Communications. We will not impose any fee to process the withdrawal of your consent to receive electronic Communications; however your access and use of the online version of the Errors & Omissions survey will be terminated. Any withdrawal of your consent to receive electronic Communications will be effective only after we have a reasonable period of time to process your withdrawal.
4. Email Address.
It is your responsibility to provide us with true, accurate and complete e-mail address and other contact information related to this Disclosure and your Account(s), and to maintain and update promptly any changes in this information. You can update information (such as your e-mail address) through the AGRONLINEFORMS or by contacting us at
212 627 7400
. 4.5 Except to the extent otherwise required by applicable law or regulation, you agree that we are under no obligation to re-send, re-transmit, or otherwise deliver to you any AGRONLINEFORMS notifications or information that we have transmitted to your e-mail address and that has been returned "undeliverable" or otherwise rejected for delivery.
4.5 Electronic Messaging and E-mail.
Your use of the Services may from time to time involve communication between you and us via e-mail, and by entering into this Agreement you are consenting to communications via e-mail. The following provisions apply to e-mail communications:
• You agree and acknowledge that the information communicated via e-mail to or from us may include information regarding any or all of the services that are part of the Services or other services we feel may be of added interest to you.
• An e-mail message sent by you will not be immediately received by us, so if you need to contact us immediately you should call the telephone number in this Agreement. No action will be made on any electronic message you send to us until we actually receive your message and have a reasonable opportunity to act on it; provided, however, that we are not obligated to comply with or take any action on any instructions, transactions, or inquiries that would violate applicable law or regulation or that are not permitted or available through the AGRONLINEFORMS. You may not use e-mail to perform any transactions or otherwise to transact any business outside the scope of the Services or the terms and conditions of this Agreement.
• You acknowledge, understand, and accept the risks of using e-mail as a means of communication of information and that we are unable to guarantee the authenticity, security, privacy, or accuracy of information received or sent by e-mail or to monitor the authorization of persons using your e-mail address to send or receive information.
• In the event you receive information from us via e-mail that you believe is intended for another recipient, you agree to immediately return the information to us and to thereafter delete the information from your computer system. You shall not use the information for any personal or commercial purposes.
• You agree that certain information communicated from us to you may be confidential in nature as a communication between you and us. You agree to maintain the confidentiality of the information and to refrain from sharing the information with any other person or entity or from using the information for any purpose that is not related to the Services provided by us.
• In the event that you believe that an unauthorized person has gained access to your computer system, you agree to immediately notify us so that we can cease communication of information to you via e-mail until corrective action is taken.
• It is your responsibility to be vigilant and protect yourself against "phishing" and other Internet frauds and schemes. We will never contact you by e-mail to ask for or to verify Passwords, or any personal information. If you receive an e-mail you believe is fraudulent from Aon, you should forward it to email@example.com. Do not respond to the e-mail or provide any information to the e-mail sender; do not click on any links in the e-mail, or otherwise comply with any instructions in the e-mail.
• Having acknowledged the risks associated with communicating via e-mail, you (a) agree that we have no obligation to monitor or investigate the use of your computer system or the source of any communication received from you bearing your e-mail address, (b) release us from any claim or liability arising from or in connection with any communications sent or received using e-mail, and (c) agree to indemnify and hold harmless us from all claims, losses, expenses or liability arising in any way out of or connected in any way with the use of e-mail as contemplated by this Agreement.
• To the extent any other agreement between you and us requires you to deliver written notice to a particular address regarding any matter, you agree that these provisions regarding the use of e-mail do not displace or modify any such requirement for a written notice, and you agree to comply with any requirement for a written notice without reference to these provisions regarding the use of e-mail. We may from time to time impose other limitations or restrictions on your use of electronic messaging and e-mail in connection with the Services.
5. Hardware and Software Requirements.
In order to access, view, and retain electronic Communications that we make available to you, you must have:
• Any of the following Internet browsers: IE8, Firefox 3.6, Chrome 10.0, Safari 5.
• an e-mail account with an Internet service provider and e-mail software in order to participate in our electronic Communications programs;
• AGRONLINEFORMS does not support mobile devices.
6. Requesting Paper Copies.
We will not send you a paper copy of any Communication, unless you request it or we otherwise deem it appropriate to do so. You can obtain a paper copy of an electronic Communication by printing it yourself or by requesting that we mail you a paper copy, provided that such request is made within a reasonable time after we first provided the electronic Communication to you. To request a paper copy, contact us by emailing firstname.lastname@example.org . We may charge you a reasonable service charge for the delivery of paper copies of any Communication provided to you electronically pursuant to this authorization. We reserve the right, but assume no obligation, to provide a paper (instead of electronic) copy of any Communication that you have authorized us to provide electronically.
7. Communications in Writing.
All Communications in either electronic or paper format from us to you will be considered "in writing." You should print or download for your records a copy of this Disclosure and any other Communication that is important to you.
8. Federal Law.
You acknowledge and agree that your consent to electronic Communications is being provided in connection with a transaction affecting interstate commerce that is subject to the federal Electronic Signatures in Global and National Commerce Act, and that you and we both intend that the Act apply to the fullest extent possible to validate our ability to conduct business with you by electronic means.
We reserve the right, in our sole discretion, to discontinue the provision of your electronic Communications, or to terminate or change the terms and conditions on which we provide electronic Communications. We will provide you with notice of any such termination or change as required by law.
By selecting "Yes, I have read and accept the above agreement," you hereby give your affirmative consent to provide electronic Communications to you as described herein. You further agree that your computer satisfies the hardware and software requirements specified above and that you have provided us with a current e-mail address at which we may send electronic Communications to you.
that I have read and agree to the Aon E-Sign Disclosure and Consent To Electronic Communications, confirming my acceptance to receive communications electronically set forth above.
'Yes, I have read and accept the above agreement'
constitues my electronic signature.
Yes, I have read and accept the above agreement
No, I do not accept above agreement
© 2010-2013 Aon/Albert G. Ruben Insurance Services, Inc.