Contractors Plant & Machinery Insurance Proposal form

Has any of the plant & machinery to be insured previously been covered by other companies?

YesNo

Have the plant & machinery to be insured been hired (partly or in total)?

YesNo

Are the plant & machinery highly exposed to special hazards?

Declaration: We hereby declare that the statements made by us in this proposal are, to the best of our knowledge and belief, complete and true, and we hereby agree that this Proposal forms the basis and is part of any policy issued in connection with the above risk(s).

Important: No insurance is in this force until this Proposal has been accepted by Company

1. Please give full description of all items on the form below including name of manufacturer, type, serial number, capacity, et..
2. Replacement value must be calculated on the current cost of replacing the machine by new machinery of same kind and capacity (inclusive of oil in the case of transformers and other electrical equipment) plus freight charges, custom duties, cost of erection