【正文】
ina , at the Request of__________________________________________________________________________________________________________________________________ and in consideration of the agreed premium being paid to the pany by the Insured, undertakes to insure the undermentioned goods in transportation subject tothe conditions of this policy as per the Clauses printed overleaf and other special Clauses attachedhereon.| 標 記 |包裝及量| 保險貨物項目 | 保險金額 ||Marks Nos.|Quantity|Description of Goods|Amount Insured||||||| | | | || | | | || | | | |總保險金額:Total Amount Insured_________________________________保 費 費率 航 班 號Premium as arranged Rate as arranged Flight 開 航 日 期 自 至 or from__________________to_____________承保險別:Conditions所保