Contractors All Risks Insurance Policy Form Page 3

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THE INSURANCE -
11. a) Estimated construction period
Months
excluding maintenance period
D
D
M
M
Y
Y
Y
Y
D
D
M
M
Y
Y
Y
Y
(cover to commence from the
From
To
date of first arrival of consignment
material at site or commencement
of work whichever is earlier)
b) Cover required during
Months
maintenance period, if any
D
D
M
M
Y
Y
Y
Y
D
D
M
M
Y
Y
Y
Y
From
To
c) Probable date on which construction
D
D
M
M
Y
Y
Y
Y
is expected to be completed
d) Period of Insurance required
Months
From
D
D
M
M
Y
Y
Y
Y
To
D
D
M
M
Y
Y
Y
Y
12. a) Have you approached any other
Yes
No
Insurance Co. for Insurance cover
in respect of this Proposal?
b) If Yes, please state name of the
Insurance Company
13. Has any such proposal been -
a) declined?
Yes
No
b) withdrawn?
Yes
No
c) accepted subject to an increased
Yes
No
rate or special conditions?
14. a) Contract works -
Note - Please attach schedule of quantities and rates and/or values (Permanent & Temporary works including all materials to be incorporated therein)
i) Contract Price
Rs.
ii) Materials or items supplied by the Principal
Rs.
iii) Any additional items not included in (a) and (b) above
Rs.
iv) Landed cost of imported items as at construction site
(please specify whether included in (i) and/or (ii) above) at Exchange Rate ________________
Rs.
TOTAL VALUE OF CONSTRUCTION
Rs.
b) Construction Plant & Machinery to be used at the construction site (Details as per attached sheet)
Rs.
c) Clearance & Removal of Debris
Rs.
d) Insured's own surrounding property.
Rs.
e) Extra charges for Express Freight (excluding Air Freight) overtime Sunday &
Rs.
Holiday rates of wages, if required.
f) Extra charges for Air Freight
Rs.
g) Additional custom duty, if any
Rs.
h) On increased Replacement value for (i) (ii) & (iv) above, if required
Rs.
(__________%)
i) Third Party Liability
- for any one accident
Rs.
- for all accidents during the period
Rs.
15. Do you wish to opt for higher amounts of Deductible Excess?
Yes
No
If Yes, whether
2 times
5 times
10 times
20 times
3

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