机器损坏险保险合同- .docVIP

机器损坏险保险合同 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. -------------------------------------------- 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,from0:00ofto24:00of| -------------------------------------------| 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| 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-----------------------| -------------------------------------------| 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 ThewordsANYONEACCIDENTchallmeananyoneaccidentorseriesofaccidentarisingoutofoneevent. 被保险机器的详细说明 SpecificationofMachinerytobeInsured 项目型号数量主要技术参数制造商制造年份保险金额维护及保用期情况 ItemModelQty.MajorTech.ManufacturerYearofManu.SumInsuredMaintenanceamp;amp;Un-expired ParameterGuaranteePeriod ---------------------------------------------------- || |________________________________________________| || |________________________________________________| || |________________________________