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保險金額Invoice Value: Amount Insured:費率 保險費Rate: Premium:備注Remarks:投保人茲聲明上述所填內(nèi)容屬實,同意以本投保單作為訂立保險合同的依據(jù);對貴公司就貨物運輸保險條款及附加險條款(包括責(zé)任免除和投保人及被保險人義務(wù)部分)的內(nèi)容及說明已經(jīng)了解。 Packing of Goods: Conditions:簽單日期Date:For and on behalf of PING AN INSURANCE COMPANY OF CHINA,LTD. authorized signature中國平安保險股份有限公司PING AN INSURANCE COMPANY OF CHINA,LTD.進出口貨 物 運 輸 險 投保單APPLICATION FOR IMP/EXP TRANPORTATION INSURANCE 被保險人Insured:本投保單由投保人如實填寫并簽章后作為向本公司投保貨物運輸保險的依據(jù),本投保單為該貨物運輸保險單的組成部分。I declare that above is true to the best of my knowledge and belief, and hereby agree that the application be incorporated into the policy. I have read and understand the Company’s cargo transportation insurance and extensions(including the Exclusions and the applicant’s or insured’s Obligations).投保人簽章: 聯(lián)系地址:Name/Seal of Proposer Address of Proposer送單地址: 同上□ 或 電話: 日期: 年 月 日Delivery Address: Ditto or Tel: Date: year month day 中國平安保險股份有限公司PING AN INSURANCE COMPANY OF CHINA,LTD.NO. 1000005959 貨 物 運 輸 保 險 單CARGO TRANPORTATION INSURANCE POLICY被保險人:Insured中國平安保險股份有限公司根據(jù)被保險人的要求及其所交付約定的保險費,按照本保險單背面所載條款與下列條款,承保下述貨物運輸保險,特立本保險單。The Applicant is required to fill in the following items in good faith and as detailed as possible,and affix signature to this application, which shall be treated as proof of application to the Company for cargo transportation insurance and constitute an integral part of the insurance policy.茲擬向中國平安財產(chǎn)保險股份有限公司投保下列貨物運輸保險:Herein apply to the Company for Transportation Insurance of following cargo:請將保險貨物項目、標(biāo)記、數(shù)量及包裝注明此上。該批貨物被“長慶 522”號輪運送出海,保險查勘代理人是中國平安保險股份有限公司曼谷分公司,信用證保險條款如下:DOCUMENTS REQUIRED: