财产保险询价书
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自动喷淋系统
Automatic Sprinkler :
完全Fully Protected
部分Partly Protected
无喷淋No Sprinklers
货架内的水喷淋喷头
In-rack Sprinklers Present in Warehouse / Storage Area :
有Yes
无No
Exposure, please give details of exposure plus distance to north, south, east and west of location :
行业描述
Occupancy :
请列出大致工艺流程
Please give the brief details of work flow & process:
% of adjusted loss, min RMBfor each and every loss
风险地址房屋数量(不包括仓库)
Number of Buildings (excluding warehouse):
总面积
Total Floor Area ______________㎡
仓库数量
Number of Warehouses :
机械设备、用具、工具但不包括任何类型工模Machinery, Utensils and Tools of Trade excluding Moulds of Any Kind
库存物及/或成品、半成品或在成Stock in Trade and/or Merchandise Manufactured, Unmanufactured or in the process of Manufacture
希望的扩展条款Please list extensions requested
租金损失
Loss of Rent
额外工作费用
Increasing Cost of Working
工资
Wages
审计师费用
Auditor’s Fees
希望的免赔额
Deductible requested :
个工作日，每一次事故损失
Working days, for each and every loss
窗体顶端
生产的瓶颈(关键的生产设备由一家供应商提供)
Production Bottlenecks:
(Critical Single Source Production Machinery, etc)
有Yes
无No
如有,请说明
If yes, please specify :
财产损失及利润损失的扩展条款Extensions for Property Damage & Consequential Loss
原材料、成品仓库及堆放区域
Raw Material & Finished Goods Storage Area :
________㎡
仓板货物堆高
Max. Pallet Storage Height :
_Biblioteka Baidu______m
货架最大高度
Max. Height of Racks :
________m
周遍情况,请给出被保险财产地址四周的情况(例如,河流,森林,纺织厂等),及其和被保险地址的距离
厂区平面图
Plant Layout Attached :
有Yes
无No
自有厂房
Owned
租用厂房
Leased
有无共用单位
Co-tenants?
有Yes
无No
合租人从事何种生产
Occupancy of cotenant :
仓库及储存区域的详细情况(请填写以下有关仓库及库存区域的信息)
Warehouse / Storage Area Details (Please fill in the information below regarding warehouse / storage)
投保下列各项
Insured Item
保险价值（帐面原值）
Book Value
保险金额/损失限额
Sum Insured / Limit
楼宇结构包括房东附属装置和设施但不包
括地基及排水设备Building including
Landlord’s Fixtures and Fittings but
excluding Foundations and Drains
商业办公家具附属装置及设施
Business and Office Furniture Fixtures and Fittings
其他(请说明)
Others(Please specify)
总额
Total
希望的免赔额
Deductible requested
人民币元，或损失之%，以高者为准，每一次事故损失
第一部分财产损失
Part IProperty Damage (If multi locations, please provide attachment with breakdown by location)
以下保险价值系按照帐面原值,如果需要按其他价值确定,请告知
Valuation is on book value basis, if other valuation is requested, please specify :
(Remark: If policy premium over RMB200,000 or US$20,000, please provide copy of operation license)
(说明:如保费超过RMB200,000或US$20,000，请提供营业执照复印件)
Business Address办公地址:
有Yes
无No
带明火操作
Fired Processes:
烤炉Oven
熔炉Furnace
其他,请说明Other, please specify
干燥机Dryer
加热器Heater
防护措施(请填写以下有关防护措施的信息)
Protection (Please fill in the information below regarding protection facilities)
日期Date :
电话Phone/Ext :
窗体顶端
被保险人
Name of Insured:
公司网站
Website:
行业性质
Occupancy:
保险期限Period of Insurance:
从From至To
被保财产地址
Locations of Property Insured:
(Please list all locations; if many, please add as attachment)
毛利润
Gross Profit :
所需赔偿期限为自损失发生之日起连续_______月数Period for which indemnity is required _______ consecutive months following the date of the damage.
备注：当要求之赔偿期限超过12个月，左侧的投保金额应为该期间预计的毛利、租金、额外工作费用和工资Remarks: Where an indemnity period in excess of 12 months is required, the respective sum insured under left side should be represent the estimated Gross Profit, Loss of Rent, ICOW and Wages for the full period selected.
请列出
Please list :
防盗报警系统
BurglarAlarm :
有Yes
无No
是否和保安公司或公安局联网
Ifyes, is itconnectedto alarm company or policestation :是Yes否No
24小时保安
24 Hours Security :
有Yes
无No
Postcode邮政编码:
Contact Person联络人:
Contact Tel. No联系电话:
Fax No传真号码:
Email Address电子邮件:
Risk Information投保资料
统一风险(Middle Market Team) 个别风险(Technical Team)
业务员Producer:
财产保险询价书
Producer Code
(Internal Use Only)
—
ProducerName
(Internal Use Only)
Policyholder Information投保单位基本信息
Name of Policyholder投保单位:
License number营业执照编号:___________________________
______________㎡
一般钢结构
Steel Structure:
________________㎡
砖木结构或木结构
Brick Joisted or Wood Structure :
______________㎡
其他结构,请说明
Other, please specify :
________________㎡
禁烟措施
Smoking ControlRegulation Present & Enforced
动火许可制度和记录
Hot work PermitPresent & Enforced
厂内自检程序和记录
Self Inspection ProgramPresent & Enforced
定期消防设施维护与记录
火警探头系统
Automatic Fire Detection:
有Yes
无No
如果有,系统联网至
If yes,connectedto:
消防局
Fire Department
控制室
Security Room
就地报警
Local Alarm
其他防火设备
Other Fire Protection Facilities:
彩钢板结构
Sandwichpanel present :
有Yes
无No
如有,请告知彩钢板结构建筑所占之______%,以及中间之保温材料:_______________
If yes, please specify ________% of construction, and type of insulation: _________________
建筑类别(请在下面填写风险地址内各种所已有的建筑类型的面积)
Construction Type (Please fill in information below regarding the area of each construction type)
钢筋混凝土结构
Reinforced Concrete Structure :
Fire Protection MaintenancePresent & Enforced
整理、整顿的规章条例与记录
Housekeeping StipulationPresent & Enforced
被保险地址附近的河流、湖泊、水库离被保险地址的距离
The distance between insured location and river / lake / reservoir close to the insured location :
工艺流程图
Production Flow Chat attached:
有Yes
无No
主要原料
Raw Material Used:
产成品
Final Product :
主要生产设备
Key Machinery, please give brief details :
大型液压设备
Hydraulic Equipment Used:
500米以内within 500 meters
超过500米above 500 meters
窗体底端
第二部分利润损失(间接损失保险)
Part II Consequential Loss Insurance
保险项目
Insured Item :
保险价值
Insured Value :
赔偿期限
Indemnity Period :
险种
Coverage Type :
财产损失
Property Damage :
火灾险
Fire Insurance :
火灾及附加灾险保险
Fire and Allied Perils Insurance:
财产一切险
Property All Risks Insurance :
间接损失保险
Consequential Loss Insurance :
Automatic Sprinkler :
完全Fully Protected
部分Partly Protected
无喷淋No Sprinklers
货架内的水喷淋喷头
In-rack Sprinklers Present in Warehouse / Storage Area :
有Yes
无No
Exposure, please give details of exposure plus distance to north, south, east and west of location :
行业描述
Occupancy :
请列出大致工艺流程
Please give the brief details of work flow & process:
% of adjusted loss, min RMBfor each and every loss
风险地址房屋数量(不包括仓库)
Number of Buildings (excluding warehouse):
总面积
Total Floor Area ______________㎡
仓库数量
Number of Warehouses :
机械设备、用具、工具但不包括任何类型工模Machinery, Utensils and Tools of Trade excluding Moulds of Any Kind
库存物及/或成品、半成品或在成Stock in Trade and/or Merchandise Manufactured, Unmanufactured or in the process of Manufacture
希望的扩展条款Please list extensions requested
租金损失
Loss of Rent
额外工作费用
Increasing Cost of Working
工资
Wages
审计师费用
Auditor’s Fees
希望的免赔额
Deductible requested :
个工作日，每一次事故损失
Working days, for each and every loss
窗体顶端
生产的瓶颈(关键的生产设备由一家供应商提供)
Production Bottlenecks:
(Critical Single Source Production Machinery, etc)
有Yes
无No
如有,请说明
If yes, please specify :
财产损失及利润损失的扩展条款Extensions for Property Damage & Consequential Loss
原材料、成品仓库及堆放区域
Raw Material & Finished Goods Storage Area :
________㎡
仓板货物堆高
Max. Pallet Storage Height :
_Biblioteka Baidu______m
货架最大高度
Max. Height of Racks :
________m
周遍情况,请给出被保险财产地址四周的情况(例如,河流,森林,纺织厂等),及其和被保险地址的距离
厂区平面图
Plant Layout Attached :
有Yes
无No
自有厂房
Owned
租用厂房
Leased
有无共用单位
Co-tenants?
有Yes
无No
合租人从事何种生产
Occupancy of cotenant :
仓库及储存区域的详细情况(请填写以下有关仓库及库存区域的信息)
Warehouse / Storage Area Details (Please fill in the information below regarding warehouse / storage)
投保下列各项
Insured Item
保险价值（帐面原值）
Book Value
保险金额/损失限额
Sum Insured / Limit
楼宇结构包括房东附属装置和设施但不包
括地基及排水设备Building including
Landlord’s Fixtures and Fittings but
excluding Foundations and Drains
商业办公家具附属装置及设施
Business and Office Furniture Fixtures and Fittings
其他(请说明)
Others(Please specify)
总额
Total
希望的免赔额
Deductible requested
人民币元，或损失之%，以高者为准，每一次事故损失
第一部分财产损失
Part IProperty Damage (If multi locations, please provide attachment with breakdown by location)
以下保险价值系按照帐面原值,如果需要按其他价值确定,请告知
Valuation is on book value basis, if other valuation is requested, please specify :
(Remark: If policy premium over RMB200,000 or US$20,000, please provide copy of operation license)
(说明:如保费超过RMB200,000或US$20,000，请提供营业执照复印件)
Business Address办公地址:
有Yes
无No
带明火操作
Fired Processes:
烤炉Oven
熔炉Furnace
其他,请说明Other, please specify
干燥机Dryer
加热器Heater
防护措施(请填写以下有关防护措施的信息)
Protection (Please fill in the information below regarding protection facilities)
日期Date :
电话Phone/Ext :
窗体顶端
被保险人
Name of Insured:
公司网站
Website:
行业性质
Occupancy:
保险期限Period of Insurance:
从From至To
被保财产地址
Locations of Property Insured:
(Please list all locations; if many, please add as attachment)
毛利润
Gross Profit :
所需赔偿期限为自损失发生之日起连续_______月数Period for which indemnity is required _______ consecutive months following the date of the damage.
备注：当要求之赔偿期限超过12个月，左侧的投保金额应为该期间预计的毛利、租金、额外工作费用和工资Remarks: Where an indemnity period in excess of 12 months is required, the respective sum insured under left side should be represent the estimated Gross Profit, Loss of Rent, ICOW and Wages for the full period selected.
请列出
Please list :
防盗报警系统
BurglarAlarm :
有Yes
无No
是否和保安公司或公安局联网
Ifyes, is itconnectedto alarm company or policestation :是Yes否No
24小时保安
24 Hours Security :
有Yes
无No
Postcode邮政编码:
Contact Person联络人:
Contact Tel. No联系电话:
Fax No传真号码:
Email Address电子邮件:
Risk Information投保资料
统一风险(Middle Market Team) 个别风险(Technical Team)
业务员Producer:
财产保险询价书
Producer Code
(Internal Use Only)
—
ProducerName
(Internal Use Only)
Policyholder Information投保单位基本信息
Name of Policyholder投保单位:
License number营业执照编号:___________________________
______________㎡
一般钢结构
Steel Structure:
________________㎡
砖木结构或木结构
Brick Joisted or Wood Structure :
______________㎡
其他结构,请说明
Other, please specify :
________________㎡
禁烟措施
Smoking ControlRegulation Present & Enforced
动火许可制度和记录
Hot work PermitPresent & Enforced
厂内自检程序和记录
Self Inspection ProgramPresent & Enforced
定期消防设施维护与记录
火警探头系统
Automatic Fire Detection:
有Yes
无No
如果有,系统联网至
If yes,connectedto:
消防局
Fire Department
控制室
Security Room
就地报警
Local Alarm
其他防火设备
Other Fire Protection Facilities:
彩钢板结构
Sandwichpanel present :
有Yes
无No
如有,请告知彩钢板结构建筑所占之______%,以及中间之保温材料:_______________
If yes, please specify ________% of construction, and type of insulation: _________________
建筑类别(请在下面填写风险地址内各种所已有的建筑类型的面积)
Construction Type (Please fill in information below regarding the area of each construction type)
钢筋混凝土结构
Reinforced Concrete Structure :
Fire Protection MaintenancePresent & Enforced
整理、整顿的规章条例与记录
Housekeeping StipulationPresent & Enforced
被保险地址附近的河流、湖泊、水库离被保险地址的距离
The distance between insured location and river / lake / reservoir close to the insured location :
工艺流程图
Production Flow Chat attached:
有Yes
无No
主要原料
Raw Material Used:
产成品
Final Product :
主要生产设备
Key Machinery, please give brief details :
大型液压设备
Hydraulic Equipment Used:
500米以内within 500 meters
超过500米above 500 meters
窗体底端
第二部分利润损失(间接损失保险)
Part II Consequential Loss Insurance
保险项目
Insured Item :
保险价值
Insured Value :
赔偿期限
Indemnity Period :
险种
Coverage Type :
财产损失
Property Damage :
火灾险
Fire Insurance :
火灾及附加灾险保险
Fire and Allied Perils Insurance:
财产一切险
Property All Risks Insurance :
间接损失保险
Consequential Loss Insurance :