Deterioration of Stock Insurance Proposal Form   Please select the country/city where the form is to be submitted -Select Country- Kuwait Lebenon Saudi Arabia U.A.E 1 Name of Proposer. 2 Address 3 Business 4 Tel No. 5 Fax No. 6 E-mail Address 7 (a) Have you a Manufacturers Guarantee? select Yes No (b) If so when does it expire? 8 (a) Have you a maintained Agreement? select Yes No (b) If so, with whom? (c) Frequency of visits? per year 9 Give particulars of:   (a) Any defect known to you in plant. (b) Any failure of the plant or failure electricty supply in the last 3 years. (c) Any loss of stock which resulterd (d) Are you maintaining the Log Record on Temperature readings? 10 (a) Has the risk been previously insured? select Yes No (b) Has any similar proposal for Insurance been previously made? select Yes No (c) In what Company or Companies? (d) Has renewal ever been declined? select Yes No (e) Has an increased rate been required? select Yes No Description of Plant Description No: Date Make HP Motor Class Goods Stored Sum Insured DECLARATION I/We declare that the above statements and particulars are true and I/We have not withheld or concealed any material information. [ To download the form please right click the Download button and select "Save target as" and Save.]  Download the Form                Download Acrobat Reader Top