平安保险投保单空白格式.doc

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1、中国平安财产保险股份有限公司PINGANPROPERTY&CASUALTYINSURANCECOMPANYOFCHINA,LTD货物运输险投保单APPLICATIONFORTRANSPORTATIONINSURANCE被保险人Insured: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。TheApplicantisrequiredtofillinthefollowingitemsingoodfaithandasdetailedaspossible,andaffi

2、xsignaturetothisapplication,whichshallbetreatedasproofofapplicationtotheCompanyforcargotransportationinsuranceandconstituteanintegralpartoftheinsurancepolicycoveringcargo.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:HereinapplytotheCompanyforTransportationInsuranceoffollowingcarg

3、o:请将保险货物项目、标记、数量及包装注明此上。Pleasestateitems,marks,quantityandpackingofcargoinsuredhereabove.请将投保的险别及条件注明如下:Pleasestaterisksinsuredagainstandconditions:装载运输工具（船名/车号）：船龄:PerConveyanceS.S.AgeofVessel集装箱运输：是£否£整船运输：是£否£ContainerLoadYesFullVesselCharterYesNo发票或提单号Invoice

4、No.orB/LNo.起运日期:Slg.onorabt.YearMonthDay自：From:经：Via:至:To:发票金额AmountInvoice:保险金额AmountInsured:费率Rate:保险费Premium:备注:合同号：Remarks: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加条款及附加险条款（包括责任免除和投保人及被保险人义务部分）的内容及说明已经了解。Ideclarethataboveistruetothebestofmyknowledge

5、andbelief,andherebyagreethattheapplicationbeincorporatedintothepolicy.IhavereadandunderstandtheCompany’scargotransportationinsuranceclausesandextensions(includingtheExclusionsandtheapplicant’sorinsured’sObligations).投保人签章:联系地址:Name/SealofProposer:AddressofPropose

6、r:送单地址:同上£或Deliveryaddress:Dittoor电话:Tel:日期:Date:YearMonthDayCopyright:我的物流吧