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1、平安保险投保单空白格式中国平安财产保险股份有限公司货 物 运 输 险 投 保 单 被保险人 PING AN PROPERTY & CASUALTY INSURANCE COMPANY OF CHINA,LTD Insured: APPLICATION FOR TRANSPORTATION INSURANCE 本投保单由投保人如实填写并签章后作为向本公司投保货物运输保险的依据, 本投保单为该货物运输保险单的组成部分。 The Applicant is required to fill in the following items in good faith and as detailed as
2、possible, and affix signature to this application, which shall be treated as proof of application to the Company for cargo transportation insurance and constitute an integral part of the insurance policy covering cargo. 兹拟向中国平安财产保险股份有限公司投保下列货物运输保险: 请将投保的险别及条件注明如下: Herein apply to the Company for Tra
3、nsportation Insurance of Please state risks insured against and conditions: following cargo: 请将保险货物项目、标记、数量及包装注明此上。 Please state items, marks, quantity and packing of cargo insured here above. 装载运输工具： 船龄: Per Conveyance S.S. Age of Vessel 集装箱运输： 是 否 整船运输： 是 否 Container Load Yes Full Vessel Charter Y
4、es No 发票或提单号 Invoice No. or B/L No. 自： 经： 起运日期: Slg. on or abt. Year Month Day 至: To: 保险金额 From: Via: 发票金额 Amount Invoice: 费率 Rate: 备注:合同号： Remarks: Amount Insured: 保险费 Premium: 投保人兹声明上述所填内容属实，同意以本投保单作为订立保险合同的依据；对贵公司就货物运输险保险条款及附款及附加险条款的内容及说明已经了解。 I declare that above is true to the best of my knowle
5、dge and belief, and hereby agree that the application be incorporated into the policy. I have read and understand the Companys cargo transportation insurance clauses and extensions(including the Exclusions and the applicants or insureds Obligations). 投保人签章: 联系地址: Name /Seal of Proposer: Address of Proposer: 送单地址: 同上 或 电话: 日期: Tel: Delivery address: Ditto or Date: Year Month Day Copyright: 我的物流吧 1
