Contractor'S All Risk Insurance Proposal Form
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3CONTRACTOR’S ALL RISK INSURANCE PROPOSAL FORM
Important: - 1. The liability of the Company does not commence until this proposal has been accepted by the Company and the premium paid. 2.
Information given herein will be treated in strict Confidence. 3. Put a ( ) mark wherever applicable.
S. No.
Details
Answer
1.
a)
Name & Address of the Principal Trade or
business
b)
Name & Address of the Contractor Trade or
business
c)
Name & Address of the Sub Contractor, if any,
Trade or Business
THE INSURED INTERESTS -
2.
Whose Interests are to be Insured?
Contractor
Sub-contractor
Principal
3.
THE CONTRACT WORKS -
a)
Full description of the Contract
b)
Please give details -
i)
Building (type of construction, number of
storeys etc.)
ii)
Blasting operation
iii)
Excavation work
iv)
Pile driving
v)
Tunneling
vi)
Dam Construction or diversion of water
vii)
Others (Specify)
Note - A site plan of contract works may be
enclosed.
4.
i)
Is this a contract/Sub-contract forming part
YES NO
of an over all construction project
ii)
If yes, give name of the Project
5.
a)
Will the construction be carried out by your
YES NO
own personnel?
b)
If not, by whom?
c)
Past experience of the Contractor
6.
d)
Will any sub-contractors be taking part in the
YES NO
work of construction?
e)
If yes, what is their position as regards this
insurance?
THE CONTRACT SITE -
7.
a)
Location of Contract site
b)
Nearest port and/or Railway Station and
distance.
Note - A complete lay out of the site may be
enclosed
8.
a)
Are any Special Risks of one or more of the
following involved?
i)
Earthquake-Fire & Shock
ii)
Landslide/Rockslide/ Subsidence
iii) Flood/Inundation
iv) Storm/Tempest/Hurricane/Typhoon/
Cyclone
v)
Collapse
vi) Water Damage for ’Wet’ risk i.e. Contract
involving construction in rivers, canals,
lakes or sea.
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