国际贸易单证实务单证样例10 货物运输投保单（空白）.docx

单证样例10货物运输投保单投保单序号:PICC No.中国人民保险公司 The People's Insurance Company of China 地址(ADD) (POST CODE) (TEL) (FAX) 货物运输保险单投保单 APPLICATION FORM FOR CARGO TRANSPORTATION INSURANCE POLICY被保险人(INSURED)发票号(INVOICE NO.) 合同号(CONTRACT NO.) 信用证号(L/C NO.)发票金额(INVOICE AMOUNT)投保加成(PLUS)%兹有以下物品向中国人民保险公司湖北省分公司投保.(INSURANCE IS REQUIRED ON THE FOLLOWINGCOMMODITIES):标记包装及数量保险货物工程保险金额MARKS & NOS. QUANTITYDESCRIPTION OF GOODS AMOUNT INSURED启运日期装载运输工具DATE OF COMMENCEMENTPER CONVEYANCE自经至FROMVIATO提单号赔款偿付地点B/L NO.CLAIM PAYABLE AT投保险别(PLEASE INDICATE THE CONDITIONS &/OR SPECIAL COVERAGES):请如实告之以下情况（如“是”在中打7，不是，在货物种类：袋装散装冷藏液体GOODS:BAG/JUMBOBULKREEFERLIQUID集装箱种类:普通J开顶1框架平板CONTAINER:ORDINARYOPENFRAMEFLAT转运工具：海轮飞机驳船火车BYTRANSIT:SHIPPLANEBARGETRAIN船舶资料：船籍船龄PARTICULAR OF SHIP:REGISTRYAGE中打“x”。IF ANY, PLEASE MARK“d"OR "x") 活动物机器/汽车危险品等级LIVE ANIMAL MACHINE/AUTO DANGEROUS CLASS 冷藏REFRIGERATOR汽车TRUCK备注:被保险人确认本保险合同条款和内容已经完全了解。投保人(签名盖章)APPLICANTS SIGNATURETHE ASSURED CONFIRMS HEREWITH THETERMS AND CONDITIONS OF THESE INSURANCE CONTRACT FULLY UNDERSTOOD. (TEL.)地址(ADD)投保日期(DATE)本公司自用(FOR OFFICE USE ONLY)费率保费备注RATE PREMIUM NOTE经办人核保人负责人BYUNDER WRITERMANAGER