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1、 安装工程一切险保险合同安装工程一切险投保单erectionallrisksinsuranceapplication保单号policyno.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安装工程险的依据。本投保单为该工程保险单的组成部分。theapplicantisrequiredtofillinfollowingitemswithutmostfaithandasdetailedaspossi-ble,andaffixsignaturetothisapplication,whichshallbethebasisofapplicationtothecompanyforerect
2、ionallrisksinsuranceandconstituteanintegralpartoftheinsurancepolicycoveringthepro-ject.1.工程关系方的名称和地址nameandaddressofpartiestoproject工程所有人principal承包人contractor工程分包人sub-contractor其他关系方otherparty(ies)concerned2.被保险人名称和地址：nameandaddressoftheinsured:3.被保险工程名称titleofcontract/project:4.被保险工程地点locationofer
3、ection:5.被保险项目、保险金额赔偿限额及每次事故免赔额insureditems、sumsinsured/limitsofindemnityanddeductibleforanyoneaccident*:5.1物质损失materialdamage项目投保金额每次事故免赔额insureditemssumsinsureddeductibleforanyoneaccident*-安装工程erectionworks(1)安装工程设备价（包括设备价、运费、保费、关税等）valueofequipmenttobeerected(includingvalueofequipment,freight,ins
4、urancepremiumandcustomsduty,etc.)(2)安装费costoferection土建项目civilengineeringwork每次事故指不论一次事故或一个事件引起的一系列事故thewordsanyoneaccidemtshallmeananyoneaccidentorseriesofaccidentarisingoutofoneevent.工程所有人或承包人在工地上的其他财产principalsorcontractorspropertyexistingonthesite施工用机具及设备（详见所附清单）constructionplantandequipment(acc
5、ordingtotheattachedlist)清除残骸费用removalofdebrisexpenses灭火费用fireextinguishmentexpenses专业费用professionalexpenses其他费用otherexpenses总保险金额totalsuminsured5.2特种危险赔偿限额limitsofindemnityforspecialrisks赔偿限额limitsofindemnity（不超过保额80%limitto80%ofsuminsured）危险种类risks地震、海啸earthquake,tsunami洪水、风暴、暴雨flood,storm,tempest每
6、次事故免赔额（不低于损失的20%）deductibleforanyoneaccident(notlessthan20%ofloss)5.3费率premiumrate5.4总保险费totalpremium6.保险期限periodofinsurance6.1安装期：个月，自年月日起至年月日止erectionperiod:months,fromto6.2试车期（可独立分开的项目单独试车）个月，自年月日起至年月日止testingorcommissioningperiod:months,fromto6.3是否投保有限责任保证期？如是，请列明是否whethermaintenancevisitsperiod
7、istobecovered?ifso,pleasestateyesno保证期个月，自年月日起至年月日止maintenancevisitsperiod:months,fromto7.是否投保第三者责任？如是，请列明是否whetherthirdpartyliabilityistobecovered?ifso,pleasestateyesno7.1每次事故赔偿限额limitofindemnityforanyoneaccident7.2累计赔偿限额limitofindemnityinaggregateduringperiodofinsurance7.3每次事故物质损失免赔额deductibleofma
8、terialdamageforanyoneaccident7.4费率及保险费premiumrateandpremium8.被安装机器设备的情况conditionofthemachineryandequipmenttobeerected8.1项目主体principlework8.2如系单项设备，逐一列明名称、型号、技术指标、制造商及价值；如系成套设备，列明主要设备的名称、技术指标、制造商及价值；如有旧品，逐一列明名称及价值forsingle-itemequipment,specifydescription,type,technicalstandard,manufacturerandvalue;f
9、orcompletesetsofequipment,specifynames,technicalstandard,manufacturerandvalueoftheprincipleequipment;forusedmachinery,ifany,specifydescriptionsandvalueseparately8.3安装前设备储存地点、条件及保管方法location,conditionandmethodoftemporarystorageoftheequipmentpriortheerection8.4主体工程施工方法及起止时间constructionmethodofprinciplepartofprojectandthedateofcommencementandexpiry9.工地及附近的自然条件naturalconditionsonandarroundthework-site:9.1地形特点topograghicalfeatures
