私人艺术品保险申请表PrivateArtInsuranceApplicationForm.PDFVIP

私人艺术品保险申请表 Private Art Insurance Application Form 一般资料 GENERAL INFORMATION 受保人名称 Name of Insured : 受保人身份证号/护照号码 NRIC No./Passport No.: 出生日期 Date of Birth: 电邮地址 Email Address 通讯地址 Mailing Address : 联络人资料 Contact Person / Details : 受保人职业/公司名称 Occupation/Company of Insured : 保险代理人及联络 Insurance Agent / Contact 各投保地址及投保额 LIMIT OF INSURANCE REQUESTED AT EACH LOCATION 各投保地址 List all the locations where property is located 投保金额Total Insured Value 1. 2. 投保物品中有否置于室外，请明列。 Do you request coverage for any item/s displayed outdoors? If so, please identify these items and their corresponding values. 建筑物数据 CONSTRUCTION (* 请选择:泥砖,砖,玻璃,安全玻璃,钢铁,石材,羊毛,织物/地毯,其他） (* Select for each : Adobe, Brick, Glass, Safety Glass, Steel, Stone, Wool, Fabric / Carpet, specify other) 地址Location 1 地址Location 2 1. 建筑材料(参考以上选择*)? Material of construction (as per above*)? 2. 建筑物类别:大厦( 7 层以上),低密度( 7 层以下),独立屋或独立建筑) Building Type : High Rise Building (over 7th storey), Low Rise Building (below 7th storey), Stand-alone House or Detached Building? 3. 大厦楼层数目? No. of floors of the building? Page 1 of 6 私人艺术品保险申请表 Private Art Insurance Application Form 4. 兴建年份? When was the building built? 5. 用途(住宅, 商业或仓库……) Occupancy (residential, commercial or warehouse……) 防火设备FIRE PROTECTION