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13位单证识别码14位单证流水号 中国人民财产保险股份有限公司 险(2009版)保险单保险单号码:*鉴于投保人已向本保险人投保 险(2009版),并按本保险合同约定交付保险费,保险人同意按照中国人民财产保险股份有限公司 险条款(2009版)及附加险条款(若投保附加险)的约定承担保险责任,特立本保险单为凭。WHEREAS THE INSURED named in the Schedule hereto has made to the PICC Property and Casualty Company Limited (hereinafter called “the Insurer ”) a written Proposal (2009 Version) which together with any other statements made by the Insured for the purpose of this Policy is deemed to be incorporated herein and has paid to the Insuer the premium stated in the Schedule.NOW THIS POLICY OF INSURANCE WITNESSES that subject to the terms and conditions (2009 Version) contained herein or endorsed hereon the Insurer shall indemnify the Insured for the loss or damage sustained during the period of insurance stated in the Schedule in the manner and to the extent hereinafter provided.明 细 表 Schedule工程名称 Name of the Project工程地址 Location of the Project投保人Applicant单位名称 Name通讯地址 Address 邮编:Postcode组织机构代码Orgnization Code联系人Contact Person联系电话Tel被保险人Insured名称和地址Name and Address组织机构代码Orgnization Code联系人及电话Contact Person and Tel建设单位/所有人 The Employer承包人 The Contractor其他关联方The other party(ies) concerned 物质损失部分 Material Damage保险项目 Insured Item保险金额/赔偿限额 Sum Insured / Limit of Indemnity每次事故免赔额(率)Deductible (ratio) for any one accident1、建筑工程(包括永久和临时工程及所用材料)Contract work (permanent and temporary work, including all materials to be incorporated herein)(1)工程承包价Contract Value(2)工程所有人提供的材料或设备Material or equipment provided by the Principle2、安装工程 Erection work(1)安装设备价 Erection Value (including value of the equipment, freight, insurance premium and tariff)(2)安装费 Erection Fee3、施工用机具及设备(详见所附清单)Construction machinery and equipment (please see the attached list)4、特约标的 items to be specifically agreed by the Insurer(1)工程所有人或承包人在工地上的其他财产Other onsite properties owned by the Principle or the Contractor(2)工地外储存财产Offsite storage Property(3)其他 Others5、附加费用 Additional Fees (1)清除残骸费用Removal of debris(2)专业费用 Professional fees(3)其他费用 Other fees物质损失总保险金额:(大写 ) Material Damage Total Sum Insured: (小写):特殊风险赔偿限额 Limit of Indemnity for Special Risks风险种类 Type of Risk赔偿限额 Limit of Indemnity每次事故免赔额(率)Deductible (ratio) for any one accident1、 地震,海啸Earthquake, tsunami2、洪水、风暴、暴雨Flood, rainstorm, storm第三者责任 Third Party Liability保险项目Insured Item责任限额Limit of Indemnity每次事故免赔额(率)Deductible (ratio) for any one accident人身伤亡Bodily injury每人 Any one person总额 In aggregate2财产损失 Property damage每次事故责任限额Limit of Indemnity for any one accident累计责任限额 Aggregate Limit总保险费:人民币(大写 ): Total Premium: RMB (小写): 保险期间 Period of Insurance建筑、安装工程保险期间:自 年 月 日至 年 月 日止 共 个月Period of Insurance for construction, erection: from to , months 其中:试 车 期: 自 年 月 日至 年 月 日止 共 天Including days of testing and commissioning, from to施工机器设备保险期间:自 年 月 日至 年 月 日止 共 个月Period of Insurance for construction machinery and equipment: from to , months司法管辖:本保险单受中华人民共和国(港、澳、台除外)司法管辖Jurisdiction: This policy is governed by law of the Peoples Republic of China ( excluding Hong Kong, Macau and Taiwan)保险合同争议解决方式Treatment of Disputes因履行本保险合同发生的争议,由双方协商解决,协商不成的,提交 仲裁委员会仲裁 All disputes arising from implementing this contract shall be settled through negotiations between the parties concerned. Upon failure to reach an agreement through negotiations, such dispute shall be referred to the arbitration commission for arbitration.因履行本保险合同发生的争议,由双方协商解决,协商不成的,依法向人民法院提起诉讼 All disputes arising from implementing this contract shall be settled through negotiations between the parties concerned. Upon failure to reach an agreement through negotiations, legal proceeding could be initiated with the Peoples Court in Peoples Republic of China.特别约定Special agreement保险人(盖章)Signature全国统一服务电话:95518 Date: 年 月 日 保险人联系地址:Address: 邮政编码:Postcode 传真:Fax: 核保: 制单: 经办: 尊敬的客户:您可通过本公司网站()、95518客服电话或附近的营业网点查询保险单信息。若对查询结果有异议,请通过以上三种渠道联系本公司。Dear customer: you can find the Policy information on our website (), by customer service hotline 95518 or in the nearby branches. Should you have any enquiries, please contact us through the abovementioned three channels 中国人民财产保险股份有限公司 工程保险免赔清单(2009版)Deductible List for Construction Insurance (2009)本清单为工程险保险单的组成部分。This list forms the effective part of the Proposal Form.保险单号码:Policy No.:被保险人:Insured:保险单号:Policy No.:工程名称:Name of the project工程地址:Location of the project保险标的或承保风险Insured Item and/or Risks Covered免赔额/免赔率Deductible/Deductible Ratio全国统一服务电话:95518 年 月 日 保险人联系地址: 邮政编码: 传真: 核保: 制单: 经办:中国人民财产保险股份有限公司 工程保险施工机器、设备保险清单(2009版)List of Construction Machinery and Equipment for Construction Insurance (2009) 本清单为工程险保险单的有效组成部分。This list forms the effective part of the Proposal Form.被保险人Insured建设单位 The Principle承包人 Contractor(s)其他关联方 Other party(ies) concerned保险标的(序号、种类、产厂家名称、性能) Insured Item ( Series No., Type, Name of manufacturer(s), Capacity数量 Quantity生产年份 Year of Manufacture保险金额 Sum Insured年费率 Annual Rate免赔额 Deductible总保险金额:(大写) Total Sum Insured: (小写)保险单号码: Policy No.: 共 页 第 页 Total pages, page保险人(盖章)全国统一服务电话:95518 年 月 日 保险人联系地址: 邮政编码: 传真: 核保: 制单: 经办:中国人民财产保险股份有限公司 工程保险附加险条款保险清单(2009版)List of Insured(s) for Construction Insurance (2009)本清单为工程险保险单的组成部分。This list forms the effective part of the Proposal Form.保险单号码:Policy No.: 1.工程名称: Name of the project 地址: Location 2.附加条款投保信息 Extension Clauses序号No.附加条款名称Name of Extension Clauses保险金额/赔偿限额Sum Insured / Limit of Indemnity每次事故免赔额/免赔率Deductible/Deductible ratio for any one accident备注Remark123456789101112131415注:对于需明确保险价值、每人赔偿限额、地域范围等信息的附加条款,请在“备注”栏内填写相关信息。Remarks: For extension clauses in which the insured value, limit of indemnity for any one person, territorial limit and other information needed to be defined, please fill the Remark column with the relevant details. 保险人(盖章)全国统一服务电话

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