机器损坏险保险合同新.docx

机器损坏险保险合同新.docx

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机器损坏险保险合同新

机器损坏险保险合同2018新

合同范本

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,whichshallbethebasisofapplicationtothecompanyformachinerybreakdowninsuranceandconstituteanintegralpartofthemachinerybreakdownin-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thewords“anyoneaccident”challmeananyoneaccidentorseriesofaccidentarisingoutofoneevent.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.suminsuredmaintenance&un-expiredparameterguaranteeperiod----------------------------------------------------|||________________________________________________||||________________________________________________||||________________________________________________|||----------------------------------------------------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.suminsuredmaintenance&un-expiredparameterguaranteeperiod----------------------------------------------------|||________________________________________________||||________________________________________________||||________________________________________________|||----------------------------------------------------说明:

（1）主要技术参数指机器的输出功率、速度、容量、负荷等,如属电器设备,应说明电压、电流量、转速,如属蒸气设备,应说明燃料、压力和温度。

（2）维护情况指自行维护（a）、由指定厂家维护（b）、由生产厂家维护（c）。

note:

（1）majortechnicalparameter:

output,speed,capacity,loadingetc.andforelectricalequipment,voltage,amperage,cycles.andforsteamequipment,fuel,pressureandtemperature.

（2）maintenance:

byinsured（a）,bycontractor（b）,bymanufacturer（c）.---------------------------------------------------------9.以前这些机器发生是否发生过损坏?

（以往5年）---是---否|previouslossesexperience（last5years）||yes||no|------|项目item_____________________________________|损坏时间breakdowntimed_____________________________________|损失金额lossamount_____________________________________|--------------------------------------------------------|10.有无制定操作规程?

---是---否|anyoperatingsystem?

ifyes,pleasestate.||yes||no|------|--------------------------------------------------------|11.操作人员operator:

|11.1新员工上岗前是否进行岗位教育和培训?

---是---否|werethenewoperatortrainedbeforetakingupnewpost?

||yes||no|------|aretheoperatorworkingwithqualiticationcertificate?

||yes||no|------|11.3平均上岗时间theaveragetimeofemploymentinthispost|--------------------------------------------------------|12.维修情况conditionofmaintenance?

|12.1有无配置专业维修人员?

---是人数---否|anytrainedmaintenanceworker?

||yesnumbers______||no|------|anydailymaintenance?

||yes||no|------|12.3大修每隔____个月进行一次ovrhaulevery______months|12.4是否按照生产厂家的要求和规定进行维修和保养?

---是---否|procedurescomplywiththerequirementofmanufacturer?

||yes||no|------|--------------------------------------------------------|13.特别条款specilaprovisions:

|--------------------------------------------------------|14.备注remarks:

|--------------------------------------------------------|投保人及被保险人兹声明所填上述内容属实,对贵公司就安装工程一切险条款及附加内容（包括责任免除部|分）的说明已经了解,同意按照该条款和附加内容投保安装工程一切险。

|i/we（theapplicant&theinsured）toherebydeclarethattheabovecontentsaretrulyfilledin,andthati/we|haveunderstoodthecompany”sexplanationontheclausesoferectionallrisksinsuranceanditsadditional|contents（includingexclusions）,andthati/weagreetoapplyforerectionallrisksinsurancesubjecttothe|above-mentionedclausesanditsadditionalcontents.|投保人及被保险人（签章）电话|signaturesoftheapplicant&theinsured____________teleph