Deterioration of stock in cold storage Insurance Proposal

ownerlessorlesseetenant
of the storage house

all the yearmonths in the year










corkmineral woolfoam plastic

YesNo
YesNo

YesNo
YesNo
Attach Documents

NH3Freon 22Freon 21Other
on the ceilingon the wallson the floor

by own staffby governmentby other

irregularregular at intervals of 3 months6 monthsother
manufacturerlessorown staffmaintenance firm

YesNo

YesNo

YesNo
AudiblyVisibly
irregularlyregularly at intervals of months by

YesNo
YesNo

YesNo
by ring mainby single dead-end feederby double dead end feeder
undergroundoverhead

YesNo
YesNo

Note: The "No-claims period" is the period (eg. 12, 24, 48 hours or more) during the goods stored cannot under any circumstances
deteriorate due to a rise in temperature as a consequence of damage indemnifiable according to the conditions of a Machinery Breakdown policy
and/or failure of power supply. The "no-claims period" depends fundamentally on the type and quantity of goods stored and on the
specific features of the cold-storage insulation used.

#Estimated maximum selling price for the goods.

Goods are: SortedPacked


Goods are: SortedPacked

Goods are: SortedPacked

Goods are: SortedPacked

Goods are: SortedPacked

Goods are: SortedPacked

Goods are: SortedPacked

Goods are: SortedPacked


Declaration:

We hereby declare 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).

NOTES:

1. (Description of items column) Please give full description of all items including name of manufacture, type, cooling capacity, speed, pressure, etc..

2. (Remarks column) Please give details of spare units or spare parts available, internal repair facilities, replacement period, etc..

3. (Replacement value column) Please state the current cost of replacing the equipment by new equipment of the same kind and capacity plus freight charges, custom duties, costs of erection