缮制保险单

根据下述给出的条件缮制一份保险单据

1．信用证资料：

L/C NO. A66789

APPLICANT: XYZ COMPANY, NEW YORK

BENEFICIARY: ABC COMPANY, NANJING

SHIPMENT FROM NANJING TO NEW YORK

MERCHANDISE: GIRLS’S SKIRTS, CIF NEW YORK

TTL AMOUNT: USD50,000.00

DOCUMENTS REQUIRED: FULL SET (2/2) OF INSURANCE POLICY IN DUPLICATE IN NEGOTIABLE FORM BLANK ENDORSED FOR 110 PERCENT OF INVOICE V ALUE COVERING OCEAN TRANSPORTATION CLAUSES ALL RISKS, STRIKES, RIOTS AND CIVIL COMMOTIONS CLAUSES OF PICC, INCL. WAREHOUSE TO WAREHOUSE, I.O.P. CLAIMS PAYABLE AT NEW YORK IN THE CURRENCY OF L/C.

信用证未对保险单据作任何其他规定。

2．附加信息：

发票号码：JS66/2007

发票显示：DESCRIPTIONS：GIRLS’ SKIRTS，100 CARTONS，CIF NEW YORK，TTL AMT：USD50,000.00

提单显示：

PORT OF LOADING：NANJING VESSEL：FREEDOM V.123

PORT OF DISCHARGE：NEW YORK ON BOARD DATE：JAN.3，2007 SHIPPING MARKS：SKIRTS——NEW YORK

保险单据的投保日期与提单的装船日期相同。

PICC 中国人民财产保险股份有限公司

PICC Property and Casualty Company Limited

总公司设于北京一九四九年创立

Head Office：Beijing Established in 1949

货物运输保险单

CARGO TRANSPORTATION INSURANCE POLICY

发票号码：(INVOICE NO.) JS66/2007保险单号次

POLICY NO.

被保险人：

INSURED:

ABC COMPANY, NANJING

中国人民财产保险股份有限公司(以下简称本公司)要求，以被保险人向本公司缴付约定的保险费为对价，按照本保险单列明条款承保下述货物运输保险，特订立本保险单。

THIS POLICY OF INSURANCE WITNESSES THAT PICC PROPERTY AND CASUALITY COMPANY LIMITED(HEREINAFTER CALLED “THE COMPANY”) AT THE REQUEST OF THE INSURED AND IN CONSIDERATION OF THE AGREED PREMIUM PAID TO THE COMPANY BY THE INSURED, UNDERTAKES TO INSURE THE UNDERMENTIONED GOODS IN TRANSPORTA TION SUBJECT TO THE CONDITIONS OF THIS POLICY AS PER THE CLAUSES PRINTED BELOW.

总保险金额：

TOTAL AMOUNT INSURED:SAY UNIT DOLLORS FIFTY FIVE THOUSAND ONLY

保费：

PERMIUM：AS ARRANGED

费率

RATE

装载运输工具：

PER CONVEYANCE S．S．：FREEDOM V.123

开航日期

SLG．ON OR ABT．JAN.3，2007 自

FROM：NANJING

经

VIA

至

TO NEW YORK

承保险别：

CONDITIONS：OCEAN TRANSPORTATION CLAUSES ALL RISKS, STRIKES, RIOTS AND CIVIL COMMOTIONS CLAUSES OF PICC, INCL. WAREHOUSE TO WAREHOUSE, I.O.P.

所保货物如发生保险单项下可能引起索赔的损失或损坏, 应立即通知本公司下述代理人查勘。如有索赔, 应向本公司提交正本保险单(本保险单共有2份正本)及有关文件。如一份正本已用于索赔，其余正本自动失效。

IN THE EVENT OF LOSS OR DAMAGE WHICH MAY RESULT IN A CLAIM UNDER THIS POLICY, IMMEDIATE NOTICE MUST BE GIVEN TO THE COMPANY OR AGENT AS MENTIONED HEREUNDER. CLAIMS, IF ANY, ONE OF THE ORIGINAL POLICY WHICH HAS BEEN ISSUED IN TWO ORIGINAL(S) TOGETHER WITH THE RELEVANT DOCUMENTS SHALL BE SURRENDERED TO THE COMPANY. IF ONE OF THE ORIGINAL POLICY HAS BEEN ACCOMPLISHED. THE OTHERS TO BE VOID.

SURVEY TO BE CARRIED OUT BY A LOCAL COMPETENT SURVEYOR. CLAIM DOCUMENTS TO BE MAILED TO THE UNDERWRITER，WE SHALL EFFECT PAYMENT BY REMITTANCE TO THE CLAIMANT.

LIBERTY MUTUAL INSURANCE COMPANY

NEW YORK TEL. 212-333-6666

中国人民财产保险股份有限公司南京市分公司

PICC Property and Casualty Company Limited

Nanjing Branch

赔款偿付地点

CLAIM PAYABLE AT NEW YORK

日期

DATE JAN.3，2007

Authorized Signature