机器损坏险保险合同 <br>
1.机器损坏险投保单 <br>
machinery breakdown insurance application <br>
保单号 <br>
policy no. <br>
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 <br>
依据。本投保单为该机器损坏险保险单的组成部分。 <br>
the applicant is required to fill in the following items with utmost faith and as detailed as pos- <br>
sible. and affix signature to this application, which shall be the basis of application to the company <br>
for machinery breakdown insurance and constitute an integral part of the machinery breakdown in- <br>
surance policy. <br>
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1.被保险人名称和地址name and address of the insured: | <br>
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2.营业性质nature of business: | <br>
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3.被保险机器所在地location of machinery to be insured: | <br>
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4.保险期限: 个月, 年 月 日零时起至 年 月 日二十四时止 | <br>
period of insurance: months, from 0:00 of to 24:00of | <br>
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5.被保险项目及保险金额insured items and sum insured | <br>
项目 保险金额 每次事故*免赔额 | <br>
insured items sum insured deductible for any one accident* | <br>
5.1 保险财产(详见背面) | <br>
property insured(look overleaf) ------------- ----------| <br>
5.2 附加费用additional expenses | <br>
清除残骸费用 | <br>
debris removal expenses ------------- ----------| <br>
灭火费用 | <br>
fire extinguishment expinses ------------- ----------| <br>
专业费用 | <br>
professional expenses ------------- ----------| <br>
其他费用 | <br>
other expenses ------------- ----------| <br>
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6.总保险金额total sum insured: | <br>
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7.保险费率premium rate: | <br>
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8.保险费premium: | <br>
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*每次事故指不论一次事故或一个事件引起的一系列事故 <br>
the words "any one accident" chall mean any one accident or series of accident arising out of one event. <br>
被保险机器的详细说明 <br>
specification of machinery to be insured <br>
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 <br>
item model qty. major tech. manufacturer year of manu. sum insured maintenance & un-expired <br>
parameter guarantee period <br>
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被保险机器的详细说明 <br>
specification of machinery to be insured <br>
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 <br>
item model qty. major tech. manufacturer year of manu. sum insured maintenance & un-expired <br>
parameter guarantee period <br>
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