Cargo Insurance Form

Client Information:

Name:

Email Address:

Postal Address:

Country

Telephone No:

Fax No:

Bank's Information:

Name:

L/c No.

Cargo Information:

Cargo Description:

Policy Value:

Maximum Value per Shipment if more than One:

Basis of Valuation:

Voyage Information:

Voyage

From:

To:

Conveyance or Transport Type:

If others specify:

Coverage:

Please select Coverage Required

Institute Cargo Clause (A)

Institute Cargo Clause (B)

Institute Cargo Clause (C)

Institute Non-Delivery (insured value) Clause

Institute TPND Clause

Institute War and Strikes Clause (Cargo)

Annual Turnover:

Note: amount to be quoted in your local currency.