Marine Proposal Form

(Forming Part of the Insurance Contract)

Bank        

Branch     

Proposer   

Commodity:

Packing     

VOYAGE:

From   To   VIA  

 

Sum Declared Currency Type

Exchange Rate Total Sum Insured in J.D

Insurance Coverage:

Clause A

Clause B

Clause C

Clause C + ND

L / T (All Risk)

L / T (Road Risk){T / L of the Consigment due to Fire, Collision, Overturning of the carrier

Total loss following total loss of the carrier

By Sea Freight

By Air Freight

By Truck

 

C & F

FOB

EX-Factory

CIF

Others

 

Transshipment Permitted   Yes No

Partial Shipment Permitted Yes No