安装工程一切险保险合同 (中英文)CONTRACT OF ERECTION ALL RISKS INSURANCE１．安装工程一切险投保单erection all risks 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安装工程险的依据。
本投保单为该工程保险单的组成部分。
the applicant is required to fill in following items with utmost faith and as d etailed as possible, and affix signature to this application, which shall be the basis ofappli cation to the company for erection all risks insurance and constitute an integral part of the insurance p olicy covering the project.1.工程关系方的名称和地址name and address of parties toproject工程所有人principal承包人contractor工程分包人sub-contractor其他关系方other party(ies)concerned2.被保险人名称和地址：name and address of theinsured:3.被保险工程名称title ofcontract/project:4.被保险工程地点 location oferection:5.被保险项目、保险金额／赔偿限额及每次事故＊免赔额insured items、sums insured/limits of indemnity and deductible for any oneaccident:5.1物质损失 material damage项目投保金额每次事故免赔额insured items sums insured deductible for any one accident安装工程erection works(1)安装工程设备价（包括设备价、运费、保费、关税等）value of equipment to beerected (including value of equipment, freight, insurancepremium and customs duty, etc.)(2)安装费 cost of erection(3)土建项目 civil engineering work(4)每次事故指不论一次事故或一个事件引起的一系列事故the words "any one accidemt" shall mean any one accident or series of acciden t arisingout of one event.工程所有人或承包人在工地上的其他财产principal"s or contractor"s propertyexisting on the site施工用机具及设备（详见所附清单）construction plant andequipment (according to the attached list)清除残骸费用 removal of debris expenses灭火费用fire extinguishment expenses专业费用professional expenses其他费用 other expenses总保险金额total sum insured5.2特种危险赔偿限额 limits of indemnity for special risks赔偿限额 limitsof indemnity（不超过保额 80% limit to 80% of suminsured）危险种类 risks地震、海啸earthquake, tsunami洪水、风暴、暴雨flood, storm, tempest每次事故免赔额（不低于损失的 20%）deductible for any one accident (not less than 20% of loss)5.3费率premium rate5.4总保险费 total premium6.保险期限 period of insurance6.1安装期：个月，自年月日起至年月日止erection period: months, from to6.2试车期（可独立分开的项目单独试车）个月，自年月日起至年月日止testing or commissioning period: months, from to6.3是否投保有限责任保证期？如是，请列明－是－否maintenance visits period is to be covered? if so, please state－yes －no保证期个月，自年月日起至年月日止maintenance visits period: months, from to7.是否投保第三者责任？如是，请列明－是－否whether third party liability is to be covered? if so, please state－yes－no7.1每次事故赔偿限额limit of indemnity for any one accident7.2累计赔偿限额limit of indemnity in aggregate during period of insurance7.3每次事故物质损失免赔额deductible of material damage for any one accident7.4费率及保险费 premium rate and premium8.被安装机器设备的情况condition of the machinery and equipment to be erected8.1项目主体 principle work8.2如系单项设备，逐一列明名称、型号、技术指标、制造商及价值；如系成套设备，列明主要设备的名称、技术指标、制造商及价值；如有旧品，逐一列明名称及价值for single-item equipment, specify description, type, technical standard, manufacturerand value; for complete sets of equipment,specify names, technical standard, manufacturerand value of the principle equipment; forused machinery, ifany, specify descriptionsand value separately8.3安装前设备储存地点、条件及保管方法location, condition and methodof temporary storage of the equipment prior the erection8.4主体工程施工方法及起止时间construction method of principle partof project and the date ofcommencement andexpiry9.工地及附近的自然条件 natural conditions on and arround thework-site: 9.1地形特点topograghical features9.2地质及底土条件geology and subsoil conditions9.3地下水水位 level of underground water9.4最近的河、湖、海的名称、距离和以往最低、一般和最高水位name and distance of the nearest river,lake and sea and their records of the lowest,normal and highest water levels9.5以往最大降雨量记录past record of the maximumrainfall（24小时，月／年 within 24hours,month/year）9.6以往遭受自然灾害（如洪水、台风）记录past record of occurrences ofnatural calamities(such as flood, typhoon)10.该工程为－－－新建－－－改建－－－扩建the project is－－－new project－－－reform/up-grade－－－extented11.安装工程在建筑物内进行还是露天进行？－－－建筑物内－－－露天the erection work will be carried out indoor or utdoor－－－indoor－－－outdoor12.施工过程中可能会造成损坏他人财产的分布情况distribution of third party"s properties which may be damaged during the periodof erection13.施工承包人是否有同类工程的施工经验或同类施工方法的经验？－－－是－－否is the contractor experienced in this type of work or erectin method －yes－no14.工程关系方中的任何一方是否已向其他保险公司投保与本工程有关的保险？any insurance relating to this project has been effected with other insurancecompany by any patries toproj－－－yes ect?是保险公司保险种类insurance company＿＿＿coverage of insurance＿＿＿保险金额－－－否sumsinsured＿－－－no15.特别条款 special porvisions:16.备注 remarks:请随同本投保单提供下列文件this application shall be submitted together with the following documents:(1)工程合同 consrtuctioncontract(2)承保金额明细表 breakdown of the contract value(3)工程设计书 blueprint of theporject(4)工程进度表 progress schedule of the erection site(5)工程地质报告 geological report of erection site(6)工地概图 sketch of the project site投保人及被保险人兹声明所填上述内容属实，对贵公司就安装工程一切险条款及附加内容（包括责任免除部分）的说明已经了解，同意按照该条款和附加内容投保安装工程一切险。