安装工程险258k.docVIP

QUESTIONNAIRE AND PROPOSAL FOR ERECTION ALL RISKS INSURANCE 安装工程一切险询价书及投保申请书 1. Title of contract if project consists of several sections, specify section s to be insured 合同名称（如果工程包括多个项目请分别列明各要保项目） 2. Location of Erection site安装工程工地地点 Country/province/district国家/省/市 City/town/village城/镇/村（邮政编码） 3. Proposer投保人 The business type of the Insured is 被保险人经营类型为: □wholly foreign-owned enterprises 外商独资 ? □Sino-foreign joint venture中外合资 □contractual joint venture/cooperative operation business 中外合作 Name s of the Overseas Investor s 境外投资者名称为_________________________________________ 4. Name and address of Principal 业主名称和地址 5. Name s and address es of Main Contractor s 总承包商名称和地址 6. Name s and address es of Subcontractor s 分包商名称和地址 7. Name s and address es of the Manufacturer of Main items 主要项目制造商名称和地址 8. Name s and address es of the Firm supervising erection 安装监督商名称和地址 9. Name and address of Consulting Engineer 工程监理名称和地址 10. Exact description of the property to be erected if second hand items are to be erected, please state 安装财产的确切描述（如果是旧设备，请说明） In case of machines: manufacturer’s name, number, type, size, capacity, weight, pressure, temperature, revolutions; 如果是安装机器，请注明制造商名，型号，编号，尺寸，容 量，重量，压力，温度，周期。 In case of complete factories: general drawing of plant, nature of civil engineering work if any 如果是安装工厂，请提供工厂的总图, 土建工程的类型（如有） 11. Period of Insurance保险期限 Commencement of insurance保险起始日期 Duration of pre-storage提前入库期 months月 Commencement of erection work安装工程的起始日期 Duration of erection/construction安装 建筑期 months月 Duration of testing 测试期 weeks星期 If Maintenance coverage required如果要求包括维修保养期 Duration of maintenance维修保养期 months月 Termination of insurance保险终止日期 12. Have plans, designs and materials of the kind used in this project been used and/or a previous constructions用过和 或试验过 Yes是 No否 tested in 本项目中所采用的计划,设计和材料是否在以前的结构中 b previous constructions by the contractor s Yes* 是 No否 由承包商用过和 或试验过 *Please give details of similar projects c