机器损坏险保险合同2019新
1.机器损坏险投保单
MACHINERY BREAKDOWN INSURANCE APPLICATION
保单号
Policy No.
本投保单由投保人尽可能如实地、详细地填写并签章后作为向本公司投保机器损坏险的
依据。本投保单为该机器损坏险保险单的组成部分。
The Applicant is required to fill in the following items with utmost faith and as detailed as pos-
sible. and affix signature to this application, which shall be the basis of application to the Company
for Machinery Breakdown Insurance and constitute an integral part of the Machinery Breakdown In-
surance Policy.
--------------------------------------------
1.被保险人名称和地址Name and Address of the Insured: |
-------------------------------------------|
2.营业性质Nature of Business: |
-------------------------------------------|
3.被保险机器所在地Location of Machinery to be Insured: |
-------------------------------------------|
4.保险期限: 个月, 年月日零时起至年月日二十四时止| Period of Insurance: Months, from 0:00 of to 24:00of |
-------------------------------------------|
5.被保险项目及保险金额Insured Items and Sum Insured |
项目保险金额每次事故*免赔额|
Insured Items Sum Insured Deductible for Any One Accident* | 5.1 保险财产(详见背面) |
Property Insured(Look Overleaf) ------------- ----------|
5.2 附加费用Additional Expenses |
清除残骸费用|
Debris Removal Expenses ------------- ----------|
灭火费用|
Fire Extinguishment Expinses ------------- ----------|
专业费用|
Professional Expenses ------------- ----------|
其他费用|
Other Expenses ------------- ----------|
-------------------------------------------|
6.总保险金额Total Sum Insured: |
-------------------------------------------|
7.保险费率Premium Rate: |
-------------------------------------------|