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1、【推荐下载】机器损坏险保险合同范文模板 (12页) =本文为word格式，下载后可方便和修改！=机器损坏险保险合同机器损坏险投保单machinery breakdown insurance application保单号policy no.本投保单由投保人尽可能如实地、详细地填写并签章后作为向本公司投保机器损坏险的依据。 本投保单为该机器损坏险保险单的组成部分。 the applicantis requiredto fillin thefollowing itemswith utmostfaith andas detailedas pos-sible.and affixsignature tot
2、his application,which shallbe thebasis ofapplication to the panyfor machinerybreakdown insuranceand constitutean integralpart ofthe machinerybreakdownin-surance policy.1.被保险人名称和地址name andaddress ofthe insured:2.营业性质nature ofbusiness:3.被保险机器所在地location ofmachinery tobe insured:4.保险期限个月，年月日零时起至年月日二十四时
3、止period ofinsurance:months,from0:00of to24:00of5.被保险项目及保险金额insured itemsand sum insured项目保险金额每次事故免赔额insured itemssum insureddeductible forany oneaident*5.1保险财产（详见背面）property insured(look overleaf)5.2附加费用additional expenses清除残骸费用debris removalexpenses灭火费用fire extinguishmentexpinses专业费用professional ex
4、penses其他费用other expenses6.总保险金额total sum insured:7.保险费率premium rate:8.保险费premium:每次事故指不论一次事故或一个事件引起的一系列事故the wordsany oneaidentchall meanany oneaident orseries ofaident arisingout ofone event.被保险机器的详细说明specification ofmachinery tobe insured项目型号数量主要技术参数制造商制造年份保险金额维护及保用期情况item modelqty.major tech.manu
5、facturer yearof manu.suminsuredmaintenance&un-expired parameterguarantee period被保险机器的详细说明specification ofmachinery tobe insured项目型号数量主要技术参数制造商制造年份保险金额维护及保用期情况item modelqty.major tech.manufacturer yearof manu.suminsuredmaintenance&un-expired parameterguarantee period说明（）主要技术参数指机器的输出功率、速度、容量、负荷等，如属电器设
6、备，应说明电压、电流量、转速，如属蒸气设备，应说明燃料、压力和温度。 （）维护情况指自行维护（）、由指定厂家维护（）、由生产厂家维护（）。 note: (1)major technicalparameter:output,speed,capacity,loading etc.and forelectrical equipment,voltage,amperage,cycles.and forsteam equipment,fuel,pressure andtemperature. (2)maintenance:by insured(a),by contractor(b),by manufact
7、urer(c).9.以前这些机器发生是否发生过损坏？（以往年）是否previous lossesexperience(last5years)yesno项目item损坏时间breakdown timed损失金额loss amount10.有无制定操作规程？是否any operatingsystem?if yes,please state.yesno11.操作人员operator:11.1新员工上岗前是否进行岗位教育和培训？是否were thenew operatortrained beforetaking upnew post?yesno11.2操作人员是否持证上岗？是否are theopera
8、tor workingwith qualiticationcertificate?yesno11.3平均上岗时间the averagetime ofemployment inthis post12.维修情况condition ofmaintenance?12.1有无配置专业维修人员？是人数否any trainedmaintenance worker?yes numbers_no12.2是否进行日常的维修和保养？是否any dailymaintenance?yesno12.3大修每隔个月进行一次ovrhaul everymonths12.4是否按照生产厂家的要求和规定进行维修和保养？是否proc
9、edures plywith therequirement ofmanufacturer?yesno13.特别条款specila provisions:14.备注remarks:投保人及被保险人兹声明所填上述内容属实，对贵公司就安装工程一切险条款及附加内容（包括责任免除部分）的说明已经了解，同意按照该条款和附加内容投保安装工程一切险。 i/we(the applicant&the insured)to herebydeclare thatthe abovecontents aretruly filledin,and thati/wehave understoodthe panys explan
10、ationon theclauses oferection all risks insuranceand itsadditionalcontents(including exclusions),and thati/we agreeto applyfor erectionallrisksinsurance subjecttotheabove-mentioned clausesand itsadditional contents.投保人及被保险人（签章）电话signatures ofthe applicant&the insuredtelephone地址日期addressdate以下内容由保险公司填写for officeuse only经办人及日期核保人及日期
