安装工程一切险保险合同

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安装工程一切险保险合同1.安装工程一切险投保单erectionallrisksinsuranceapplication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安装工程险的依据。本投保单为该工程保险单的组成部分。theapplicantisrequiredtofillinfollowingitemswithutmostfaithandasdetailedaspossi-ble,andaffixsignaturetothisapplication,whichshallbethebasisofapplicationtothecompanyforerectionallrisksinsuranceandconstituteanintegralpartoftheinsurancepolicycoveringthepro-ject.---------------------------------------------------1.工程关系方的名称和地址|nameandaddressofpartiestoproject|工程所有人|principal-----------|承包人|contractor-----------|工程分包人|sub-contractor-----------|其他关系方|otherparty(ies)concerned-----------|--------------------------------------------------|2.被保险人名称和地址:|nameandaddressoftheinsured:|--------------------------------------------------|3.被保险工程名称|titleofcontract/project:|--------------------------------------------------|4.被保险工程地点locationoferection:|--------------------------------------------------|5.被保险项目、保险金额/赔偿限额及每次事故*免赔额|insureditems、sumsinsured/limitsofindemnityanddeductibleforanyoneaccident*:|5.1物质损失materialdamage|项目投保金额每次事故免赔额|insureditemssumsinsureddeductibleforanyoneaccident*|--------------------------------------------------------|安装工程|erectionworks|(1)安装工程设备价|(包括设备价、运费、保费、关税等)|valueofequipmenttobeerected(including|valueofequipment,freight,insurance|premiumandcustomsduty,etc.)-----------|(2)安装费|costoferection-----------|土建项目|civilengineeringwork-----------|---------------------------------------------------*每次事故指不论一次事故或一个事件引起的一系列事故thewordsanyoneaccidemtshallmeananyoneaccidentorseriesofaccidentarisingoutofoneevent.-------------------------------------------------------------工程所有人或承包人在工地上的其他财产|principalsorcontractorspropertyexisting|onthesite-----------|施工用机具及设备(详见所附清单)|constructionplantandequipment|(accordingtotheattachedlist)-----------|清除残骸费用|removalofdebrisexpenses-----------|灭火费用|fireextinguishmentexpenses-----------|专业费用|professionalexpenses-----------|其他费用|otherexpenses-----------|总保险金额|totalsuminsured-----------|5.2特种危险赔偿限额limitsofindemnityforspecialrisks|赔偿限额limitsofindemnity(不超过保额80%limitto80%ofsuminsured)|危险种类risks------------------------------------|地震、海啸|earthquake,tsunami-----------|洪水、风暴、暴雨|flood,storm,tempest-----------|每次事故免赔额(不低于损失的20%)|deductibleforanyoneaccident(notlessthan20%ofloss)-----------|5.3费率|premiumrate-----------|5.4总保险费|totalpremium-----------|------------------------------------------------------------|6.保险期限periodofinsurance|6.1安装期:个月,自年月日起至年月日止|erectionperiod:months,fromto|6.2试车期(可独立分开的项目单独试车)个月,自年月日起至年月日止|testingorcommissioningperiod:months,fromto|6.3是否投保有限责任保证期?如是,请列明---是---否||||||whethermaintenancevisitsperiodistobecovered?ifso,pleasestate---yes---no|保证期个月,自年月日起至年月日止|maintenancevisitsperiod:months,fromto|------------------------------------------------------------|7.是否投保第三者责任?如是,请列明---是---否||||||whetherthirdpartyliabilityistobecovered?ifso,pleasestate---yes---no|7.1每次事故赔偿限额|limitofindemnityforanyoneaccident-----------|7.2累计赔偿限额|limitofindemnityinaggregateduringperiodofinsurance-----------|7.3每次事故物质损失免赔额|deductibleofmaterialdamageforanyoneaccident-----------|7.4费率及保险费|premiumrateandpremium-----------|------------------------------------------------------------|8.被安装机器设备的情况conditionofthemachineryandequipmenttobeerected|---------------------------------------------------------------------------------------------------------------------8.1项目主体|principlework-----------|8.2如系单项设备,逐一列明名称、型号、技术指标、|制造商及价值;如系成套设备,列明主要设备的|名称、技术指标、制造商及价值;如有旧品,逐|一列明名称及价值|forsingle-itemequipment,specifydescription,|type,technicalstandard,manufacturerand|value;forcompletesetsofequipment,specify|names,technicalstandard,manufacturerand|valueoftheprincipleequipment;forused|machinery,ifany,specifydescriptionsand|valueseparately-----------|8.3安装前设备储存地点、条件及保管方法|location,conditionandmethodoftemporary|storageoftheequipmentpriortheerection-----------|8.4主体工程施工方法及起止时间|constructionmethodofprinciplepartof|projectandthedateofcommencement|andexpiry-----------|-------------------------------------------------------|9.工地及附近的自然条件naturalconditionsonandarroundthework-site:|9.1地形特点|topograghicalfeatures-----------|9.2地质及底土条件|geologyandsubsoilconditions-----------|9.3地下水水位|levelofundergroundwater-----------|9.4最近的河、湖、海的名称、距离和以往最低、一般和最高水位|nameanddistanceofthenearestriver,|lakeandseaandtheirrecordsofthe|lowest,normalandhighestwaterlevels-----------|9.5以往最大降雨量记录pastrecordofthemaximumrainfall|(24小时,月/年within24hours,month/year)-----------|9.6以往遭受自然灾害(如洪水、台风)记录|pastrecordofoccurrencesofnatural|calamities(suchasflood,typhoon)-----------||-------------------------------------------------------|10.该工程为---新建---改建---扩建||||||||theprojectis---newproject---reform/up-grade---extented|-------------------------------------------------------|11.安装工程在建筑物内进行还是露天进行?---建筑物内---露天||||||theerectionworkwillbecarriedoutindoororoutdoor---indoor---outdoor|-------------------------------------------------------|12.施工过程中可能会造成损坏他人财产的分布情况|distributionofthirdpartyspropertieswhichmaybedamagedduringtheperiodoferection|----------------------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