机器损坏险投保单
machinery breakdown insurance application
保单号:___________________
policy no. ________________
本投保单由投保人尽可能如实地、详细地填写并签章后作为向本公司投保机器损坏险的依据。本投保单为该机器损坏险保险单的组成部分。
the applicant is required to fill in the following items with utmost faith and as detailed as pos-sible. and affix signature to this application, which shall be the basis of application to the company for machinery breakdown insurance and constitute an integral part of the machinery breakdown in-surance policy.
1.被保险人名称和地址name and address of the insured:
2.营业性质nature of business:
3.被保险机器所在地location of machinery to be insured:
4.保险期限: 个月, 年 月 日零时起至 年 月 &n
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