Sun Flower

OR AIRLINE
或航空公司

AIRWAY BILL NO.
航空付貨單號碼

OR BY PARCEL/COURIER
或付郵寄或速遞

RECEIPT NO.
收據號碼

MARKS & NUMBERS 印記及號碼

DESCRIPTION OF GOODS 貨物及數量
(Please specify number of pkgs. and quantity of goods)

FOR OFFICE USE ONLY

Policy No:
Draft No.:

Rate: % $
Min. : $

L-1: % $
Min. : $

L-2: % $
Min. : $
N.A.: % $
Min. : $

N.P.: % $
Min. : $

PLEASE TICK NATURE OF SHIPMENT AS APPROPRIATE:

FULL CONTAINER LOAD

LESS CONTAINER LOAD

(CLOSED HARD TOP)

(OPEN TOP)

(CFS CONSOLIDATED CONTAINER)

CONVENTIONAL SHIPMENT

CHARTERED VESSEL

BULK SHIPMENT

ON DECK SHIPMENT

UNDER DECK SHIPMENT

BY BARGE/LIGHTER

COVER REQUIRED
INSTITUTE CARGO CLAUSES (A)/(AIR) (INCLUDING BREAKAGE)
INSTITUTE CARGO CLAUSES (A)/(AIR) (EXCLUDING BREAKAGE)
INSTITUTE CARGO CLAUSES (B)
INSTITUTE CARGO CLAUSES (C)
INSTITUTE WAR CLAUSES
INSTITUTE STRIKES CLAUSES
INSTITUTE THEFT, PILFERAGE AND NON DELIVERY CLAUSE
COMPUTER MILLENNIUM CLAUSE (CARGO)

OTHERS (Please Specify)

CLAIMS, IF ANY PAYABLE AT 賠款地點

Policy required: 保單須

SIGNATURE OF APPLICANT 投保者簽名及蓋章

Original 正本

Duplicate 副本

Triplicate 第三張

Copies 底紙

RE: COVER NOTE/OPEN POLICY NO.

DATE OF APPLICATION 投保日期

NAME OF ASSURED 保戶名稱	NAME OF BANK(OR OTHER INTERESTED PARTY)銀行或有關商號
INSURED VALUE 保額	INDICATE INVOICE VALUE (FOB/C&F/CIF) 發票單額 ( Added 已加 / Not added 未加 10%)
VESSEL NAME/FLIGHT NUMBER 船名/航機編號	SAILING / DESPATCHING ON / ABOUT 啟航或付寄日期
FROM 由 TRANSHIPMENT AT 轉	TO 至 ULTIMATE DESTINATION 終點

CARGO INSURANCE REQUEST FORM

貨物運輸保險報價申請表