Marine Land Transit – Annual Cover ← BackThank you for your response. ✨ INSURED NAME(required) COMPLETE ADDRESS (required) TELEPHONE NUMBER(required) EMAIL ID(required) CONTACT PERSON(required) MOBILE NUMBER(required) DETAILS OF BUSINESS ACTIVITY(required) DESCRIPTION OF GOODS(required) BRAND NEW SECOND HAND FRAGILE OTHERS IF OTHERS, PLEASE CLARIFY DESCRIPTION AND GOODS(required) DESCRIPTION OF PACKING(required) CONTAINERIZED NON-CONTAINERIZED DETAILS AND REGISTRATION NUMBERS OF OWNED VEHICLES AND TYPE OF VEHICLES(required) IF TRANSPORTED BY LAND, PLEASE PROVIDE NAME OF TRANSPORTER ADDRESS OF TRANSPORTER TELEPHONE NUMBER OF TRANSPORTER DOES THE TRANSPORTER HAVE HAULIER’S LIABILITY INSURANCE POLICY? YES NO IF YES, PLEASE PROVIDE HAULIER’S LIABILITY INSURER AND POLICY NUMBER GEOGRAPHICAL AREA(required) ESTIMATED ANNUAL CARRYINGS(required) MINIMUM VALUE PER SHIPMENT(required) MAXIMUM VALUE PER SHIPMENT(required) BASIS OF VALUATION(required) COVER OR RISKS TO BE INSURED AGAINST(required) Land Transit Clause (Ordinary) Only LOSS RECORD FOR THE PAST 3-5 YEARS(required) OTHER DETAILS OR ANY SPECIFIC REQUIREMENTS, PLEASE CLARIFY We hereby declare that the statements made by us in this online questionnaire are, to the best of our knowledge and belief, complete and true and we hereby agree that this online questionnaire forms the basis and is part of any policy issued in connection with the above proposed risks. (required) Submit Δ Like Loading...
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