THE INSURED INTERESTS Whose interests are to be insured ? PrincipalContractorSub-Contractor
THE CONTRACT WORKS Is this a contract/ sub- contract forming part of an overall erection project of value exceeding DHS.3,000,000 YesNo
Have the plans, design and Materials been already tested in any previous erection? YesNo
Is the Installation or part thereof built for the first time YesNo
What is your role in the installation? ManufacturerImporterBuyerContractor
Is the property brand new / second hand or used one? Brand NewSecond HandUsed If second hand or used state the age
Will the erection be carried out by your own personnel? YesNo
Will any sub-contractors be taking part in the work of erection? YesNo If yes, what is their position as regards this insurance?
THE CONTRACT SITE
Note: A complete layout of the factory and site may be enclosed)
Are any special risks of floods, fire or explosion involved YesNo
Is there any record of the erection site having been submerged during floods? YesNo
Will there be a watchman on duty round the clock? YesNo If not what precautions will be taken against theft, malicious damage etc?
THE INSURANCE
Period of insurance required including Test Run
SUM INSURED
(a) On landed cost of imported machinery as at Factory Site i.e @ Exchange rate (sub divided as under)
(b) On Machinery fabricated or manufactured in UAE (sub divided as under)
(c) On Cost of Erection, including Salaries of all foreign and UAE Technicians and Wages of all skilled and unskilled labour employed at factory site during erection
(d) On Building in which the above Plant & Machinery is to be erected
Third Party Liability:
Have you approached any other Insurance Co.for Insurance Cover in respect of this proposal? YesNo
Has any such proposal been declined? YesNo Has any such proposal been withdrawn? YesNo Has any such proposal been accepted subject to an increased rate or special conditions? YesNo
The following questions are to be answered if Marine/ Transit Insurance Cover is required
Are there any fragile items like Refractory materials, Asbestos Cement sheets, Porcelain materials, Glass Equipments, Fire Bricks Graphite Electrode etc YesNo If yes please give their value, full description and mode of packing (whether packed in case or loose)
Do you want cement to be covered? YesNo If yes, give its value and mode of packing (whether packed in gummy bags or paper bags)
Please give particulars of voyage for imports
Do you require War & S.R.C.C risk to be covered during overseas / inland transit? YesNo
DECLARATION I / We the underdesigned 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 company
We hereby accept the terms and conditions of the above declaration
