《财产一切险风险问询表 Property All Risks Insurance Questionnaire.doc》由会员分享,可在线阅读,更多相关《财产一切险风险问询表 Property All Risks Insurance Questionnaire.doc(6页珍藏版)》请在金锄头文库上搜索。
1、 Shenzhen Tongbao Insurance Broker Co., Ltd.深圳市通保保险经纪有限公司Rm 1917,Pacific Business Building,Jiabin Rd,Luohu,Shenzhen Tel:0755-82136473 Fax:0755-82136086深圳罗湖区嘉宾路太平洋商贸大厦1917室 邮编:518001 电话:0755-82136473 传真:0755-82136086 财产险风险问卷Questionnaire for Property Insurance请如实告知以下情况:Please provide the following in
2、formation to your best knowledge, complete and true:1.投保人名称及地址 Name and Address of Proposer2.被保险人名称及地址Name and Address of Insured3.经营内容 Business4.保险财产项目和地址Items and Respective Address(es) of Insured Property5.保险财产价值 Value of Insured Property财产类别Classes财产项目Items申报金额Declared amount建筑物Building机器设备Machi
3、nery & Equipment仓储物品Stock注:仓储物品的申报金额栏请填写最近五年的任一时点的最大存量(金额)。6.建筑物状况Status of construction名称Name建筑结构Building construction高度(米)Height (m)建筑物年龄Years of construction用途Use建筑面积Area建筑结构:1)钢筋混凝土 2)钢结构 3)钢混,砖混或钢结构 4)砖混 5)木结构或其它不明结构Building construction: 1) reinforced concrete 2) steel framework 3) steel reinf
4、orced concrete, brick reinforced concrete or steel framework 4) brick reinforced concrete 5) timber or other framework7.机器设备:Machinery & Equipment 名称Name类型及型号Type生产厂商Manufacturer制造国家Country生产年份Year of manufacture其它Others8.原材料/在产品/成品状况Raw materials/goods in progress/finished goods名称Name原材料/在产品/成品Raw
5、materials/goods in progress/finished goods存放地Place of storage盗窃风险程度Theft hazard是否危险品Dangerous goods or not是否主要原材料Major raw material or not9.周围环境 Surroundings1) 描述周围建筑物、社区情况(方位/距离)Describe vicinal buildings and compounds, if any 2) 最近的江、湖、海的名称、距离Name and distance of nearest river, lake or sea, if any
6、3) 距最近消防队距离及所需时间Access to the nearest fire brigade 4) 是否出于低洼地带 是 否Whether it is located at low water level Yes No5) 洪水警戒线 以上 以下Flood warning line Above Below10.主要自然灾害及通常发生季节Major natural hazards and seasons of occurrence地震 洪水 台风 暴雨 其他Earthquake Flood Typhoon Storm Others11.企业安全/防范情况:Security/precaut
7、ion control1)有无制作安全操作规程? 有 无 Is there any safety operation manual? Yes No2)有无自己的消防队? 有 无 Does it have its own fire brigade Yes NoIf yes, please state number of staff 人(staffs) 3)有无报警系统? 有 无 Is there any alarm system? Yes No4)有无设置便携式灭火器? 有 无 Is there equipped with portable fire extinguisher? Yes No5)
8、有无充分水源? 有 无 Is there any adequacy water source Yes No6)有无禁烟区? 有 无 Is there any non-smoking area? Yes No7)有无自动喷淋装置? 有 无 如有,请列明数量及安装方位 Yes No Is there any automatic sprinkler If yes, please state quantity and place8)其他消防设施情况(请列明种类/数量及安放地点) Other fire apparatus (Please state type/quantity/place)9)以下时间内
9、是否有值班? 日常工作时间 节假日 夜间 Are there any employees on duty? Routine work time Holiday Night10)其他保安措施(防盗等): Other security measures (e.g. anti-theft, etc.)12仓储物品:Storage goods1)是否有专人看管? 是 否 Is there any full time guard? Yes No2)易燃易爆物品是否存放在独立的危险仓库内? 是 否 Are those combustible, explosive goods kept in separat
10、e warehouses? Yes No3)请说明上述危险品仓库与其他建筑物的最小间距 Please indicate the minimum distance between the above warehouses and other buildings4)是否有消防设施? 是 否 Is there any fire apparatus? Yes No如有,请列明If yes, please state 5)仓储处是否有紧急报警系统? 是 否 Is there any emergency alarm system in the warehouse? Yes No6)仓储处是否定期进行清理? 是 否 Are the warehouses cleaned regularly? Yes No如是,请说明清理频率If yes, please state frequency 7)仓储处是否有紧急