Marine/Air Cargo proposal

Name of assured
Email
Address
Name of beneficiary
Email
Address
Subject matter insured
Are goods new or used? If used, What is the evaluation basis?
Packing
Method of shipping
Is it inside container?
YesNo
L / C Number
Bank
Vessel Name IMO#
Port of charge
Port of final discharge
Date of sailing
Voyage From
to
Name of supplier / Buyer
Invoice Amount
Exchange rate

Amount insured equal ( invoice value + % from the invoice value)
Sum insured
Issuing currency
Value of the maximum limit per truck ( If coverage till warehouses ) :
Condition of converge
Institute cargo clauses (A) / (B) / (C) / (T.L.O)
Institute war & Strikes clauses
YesNo
Name
Date