1. Purpose
This Declaration records the Host's independently obtained motor insurance, its validity and express permission for the actual rental, sharing or chauffeur use and drivers. DRYVE247 does not provide, arrange or administer this insurance, and checking the declaration does not guarantee coverage or payment.
2. Fillable Insurance Declaration Form
DRYVE247 LTD — HOST INSURANCE DECLARATION
1. VEHICLE & HOST INFORMATION
Vehicle Registration Number: [Host-provided value] Make & Model: [Host-provided value]
VIN (Chassis Number): [Host-provided value] Year: [Host-provided value]
Host Legal Name: [Host-provided value]
Host Ghana Card PIN: [ GHA-____________________-_ ] Phone: [Host-provided value]
2. PRIMARY MOTOR INSURANCE POLICY PARTICULARS
Underwriting Insurance Company: [Host-provided value]
(Must be licensed by National Insurance Commission — NIC Ghana)
Host-appointed Licensed Broker (if any): [Host-provided value]
Policy Number: [Host-provided value] Certificate No: [Host-provided value]
Policy Type: [ ] Comprehensive Motor Insurance (MANDATORY)
[ ] Commercial rental/use permission attached (MANDATORY)
Policy Inception Date: [ YYYY-MM-DD ] Policy Expiration Date: [ YYYY-MM-DD ]
3. NIC MOTOR INSURANCE DATABASE (MID) COMPLIANCE
NIC MID Sticker Serial Number: [Host-provided value]
Sticker Scannable QR Code: [ ] Verified Active on NIC MID Portal
Windscreen Sticker Affixed? [ ] YES — Lower Left Corner of Windscreen
Scanned Certificate Uploaded? [ ] YES (Attached to Digital File)
4. COMMERCIAL HIRE & VEHICLE SHARING ENDORSEMENTS
Required Host Insurance Acknowledgment:
[ ] HOST-ARRANGED COMMERCIAL COMPREHENSIVE INSURANCE
I solemnly declare that my Comprehensive Insurance policy includes an explicit, written
endorsement or rider permitting "Commercial Hire", "Self-Drive Rental", or "Peer-to-Peer
Car Sharing", and that my insurer has been notified in writing of commercial platform use.
Applicable Policy Deductible / Excess: GH₵ [Host-provided value]
[ ] NO PLATFORM INSURANCE OR ENROLLMENT
I obtain and maintain insurance directly with my chosen licensed insurer or broker.
DRYVE247 provides no insurance, collects no insurance premium and does not administer my claim.
There is no platform policy alternative; I pay my insurer directly, without premium deductions.
5. STATUTORY UNDERTAKINGS & LEGAL AFFIDAVIT
I, the undersigned Host, do hereby solemnly declare that:
1. The insurance details provided above are true, accurate, and currently in full legal force;
2. I shall not permit the insurance policy to lapse, cancel, or default during any active platform trip;
3. In the event of any policy modification, cancellation, or notice of non-renewal from my insurer,
I shall notify DRYVE247 in writing within twelve (12) hours;
4. I remain responsible for maintaining suitable cover and dealing directly with my insurer.
DRYVE247 does not guarantee insurer payment or reimburse a rejected or unpaid claim.
Any resulting liability is determined by the applicable agreements, evidence and law.
Host Full Name: [Host-provided value]
Host Digital Signature: ____________________________________ Date: [ YYYY-MM-DD HH:MM GMT ]
Electronic Audit Hash: [ SHA-256: _______________________________________________________ ]