Contractors All Risk (CAR) Insurance Proposal Form

Name of Principal:*

Address of Principal:*

Name of Contractor:*

Address of Contractor:*

Any Sub-Contractor involved (Indicate with specialized area of involvement along with addres

THE CONTRACT WORKS

a) Full description of the Contract

b) Contract Site Location

THE INSURANCE

Est. Construction Period (excl. maintenance period):FROM

Est. Construction Period (excl. maintenance period):TO

Maintenance Period: FROM

Maintenance Period: TO

SUM INSURED

1) Contract Price/Value

2) Value of Materials/Items

3) Value of Construction Plant, Equipment & Machinery

4) Principal's Existing & Surrounding Property

5) Removal of Debris

vi) Third Party Liability

a) For Bodily Injury: Any one Person/Property Damage

b) All Injuries/All Accidents: Aggregate during the period of policy

DECLARATION
I/We the undersigned hereby declare that the above statements and particulars are true and complete and I/We declare and agree that this declaration and the answers given above shall be held to be promissory and shall be the basis of the contract between me/us and The Oriental Insurance Company Limited.

We accept the terms & Conditions of the above declaration.