第1页共22页本文格式为Word版下载后可任意编辑和复制机器损坏险保险合同1
机器损坏险投保单MACHINERYBREAKDOWNINSURANCEAPPLICATION保单号PolicyNo
本投保单由投保人尽可能照实地、具体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
TheApplicantisrequiredtofillinthefollowingitemswithutmostfaithandasdetailedaspos-sible
andaffixsignaturetothisapplication,whichshallbethebasisofapplicationtotheCompanyforMachineryBreakdownInsuranceandconstituteanintegralpartoftheMachineryBreakdownIn-第2页共22页本文格式为Word版下载后可任意编辑和复制surancePolicy
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被保险人名称和地址NameandAddressoftheInsured:|-------------------------------------------|2
营业性质NatureofBusiness:|-------------------------------------------|3
被保险机器所在地LocationofMachinerytobeInsured:|-------------------------------------------|4
保险期限:个月,年月日零时起至年月日二十四时止|PeriodofInsurance:Months,from0:00ofto24:00o