机器损坏险保险合同范本.doc

机器损坏险保险合同范本 1、首页2、项目3、平均上岗时间 机器损坏险保险合同 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: | -------------------------------------------| .营业性质Nature of Business: | -------------------------------------------| .被保险机器所在地Location of Machinery to be Insured: | -------------------------------------------| .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 4:00of | -------------------------------------------| .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* | .1 保险财产(详见背面) | Property Insured(Look Overleaf) ------------- ----------| .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 -------------