GENERAL INSURANCE FOR FIRE INSURANCE

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Fire Proposal

  • POLICY NO:PREMIUM:RATE:
  • CellHomwWork
  • FromTo
  • PROPERTY TO BE INSURED

    Where insurance on Buildings is required a separate sum insured must be
    given for each separate building, and for insurance of Contents a separate
    sum insured must be given for the Contents contained in each separate
    building (if more than one building continue on separate sheet).


    Cover: Fire, Hurricane, Earthquake
  • *NOTE Unless expressly mentioned the Insurance will not cover: (I) bullion or unseat precious stones. (II) any curiosity or work of art for an amount exceeding (III) manuscripts, plans, drawings or designs, patterns, models or moulds. (IV) securities, obligations or documents of any kind, stamps, coined or paper money, cheques, books of account or other business books. (V) explosives
  • 7. Give the following particulars of any building within 10 feet of the property to be insured:
  • (Note: The above information can be linked with sketch plan)
  • Give the following particulars of each separate building to be insured or in which the property to be insured is situated (if more than one building continue on separate sheet)
  • (a) Power usedBrief Details of Process
  • ElectricityOthers
  • Note: Where premises consist of two or more buildings a sketch plan should be given.
    DECLARATION: I/We desire to effect with the Company an insurance in the terms of the policy used for this class of business and I/We declare that the above statements and particulars are correct. I/We agree that this proposal shall be the basis of the contract between me/us and the Company.
  • Date Format: MM slash DD slash YYYY
  • The Insurance will not be in force until the proposal has been accepted by the Company and the premium paid.