1.机器损坏险投保单
machinerybreakdowninsuranceapplication
保单号
policyno.
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。
theapplicantisrequiredtofillinthefollowingitemswithutmostfaithandasdetailedaspos-
sible.andaffixsignaturetothisapplication,whichshallbethebasisofapplicationtothecompany
formachinerybreakdowninsuranceandconstituteanintegralpartofthemachinerybreakdownin-
surancepolicy.
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1.被保险人名称和地址nameandaddressoftheinsured:|
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2.营业性质natureofbusiness:|
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3.被保险机器所在地locationofmachinerytobeinsured:|
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4.保险期限:个月,年月日零时起至年月日二十四时止|
periodofinsurance:months,from0:00ofto24:00of|
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5.被保险项目及保险金额insureditemsandsuminsured|
项目保险金额每次事故*免赔额|
insureditemssuminsureddeductibleforanyoneaccident*|
5.1保险财产(详见背面)|
propertyinsured(lookoverleaf)-----------------------|
5.2附加费用additionalexpenses|
清除残骸费用|
debrisremovalexpenses-----------------------|
灭火费用|
fireextinguishmentexpinses-----------------------|
专业费用|
professionalexpenses-----------------------|
其他费用|
otherexpenses-----------------------|
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6.总保险金额totalsuminsured:|
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7.保险费率premiumrate:|
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8.保险费premium:|