机器损坏险保险合同

详细内容

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,whichshallbethebasisofapplicationtothepanyformachinerybreakdowninsuranceandconstituteanintegralpartofthemachinerybreakdownin-surancepolicy. 

1.被保险人名称和地址nameandaddressoftheinsured:

2.营业性质natureofbusiness:

3.被保险机器所在地locationofmachinerytobeinsured:

4.保险期限：       个月，   年   月   日零时起至   年   月   日二十四时止

periodofinsurance:       months,from0:00of   to24:00of

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

insureditems      suminsured        deductibleforanyoneaident* 

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

6.总保险金额totalsuminsured:

7.保险费率premiumrate:

8.保险费premium:

＊每次事故指不论一次事故或一个事件引起的一系列事故 

thewordsanyoneaidentchallmeananyoneaidentorseriesofaidentarisingoutofoneevent.  

被保险机器的详细说明 

specificationofmachinerytobeinsured 

项目

item

型号

model

数量

qty.

主要技术参数

majortech.parameter

制造商manufacturer