Contractors All Risk

Date of commencement of work

Duration of Contract (In Month)

Maintenance Period (in Month)

Date of completion of work

Title of contract

Site

Town/Location construction is being carried

Town

County

Earth Quake Zone

Name

Postal address

Postal code

Telephone/Mobile no.

Email Id

Are there any Subcontractor?

Subcontractor details:

Type

Name

Postal address

Postal code

Telephone/Mobile no.

Email Id

Work to be carried out

Sub contracted work price

Description of Work to be carried out

Description of dimensions (in meters):

Length (metres)

Height (metres)

Depth (metres)

Spans (meters)

Number of floors

Number of basement levels

Type of foundation and deepest level of excavation

Construction method

Will you be constructing any Bridges, Tunnels or Overpasses?

Type of roads

Number of lanes / Tracks

Must traffic be maintained during construction of the road?

Will the new road be open to traffic before completion of wearing course?

Is the contractor experienced in this type of work or construction method?

How many years’ experience does the contractor have in this type of work?

Is the design of the structure to be insured based on regulations for earthquake-resistant structures?

Is the design standard higher than that stipulated in the relevant regulations?

Filled ground

Other

Do geological faults exist in the vicinity?

Please provide the following information on the nearest lake, river or ocean:

Name

Distance from site(in Km)

Average water level(in mm)

Highest water level recorded(in mm)

Please select the usual start month of the longest rainy season

Please select the usual end month of the longest rainy season

What is the maximum rainfall recorded in the area(in mm)

Storm Hazard

Details of existing buildings or surrounding property possibly affected by the contract work

Construction machinery, plant and equipment

Description of item

Make

Model

Serial number

Replacement value

Are existing buildings and/or structures on or adjacent to the site, owned by or held in care, custody or control of the contractor(s) or the principal, to be insured against loss or damage arising as a direct or indirect consequence of the contract work?

Exact description of these buildings/structures

Please state the amounts you wish to insure and the limits of indemnity required for the following items

Contract price

Materials or items supplied by the principal(s)

Construction machinery, plant and equipment

Earthquake, volcanism, tsunami

Storm, cyclone, flood, inundation, landslide

Existing buildings or structures on or adjacent to site

Extra charges for Overtime

Clearance of debris

Works taken over or put into service

Vibration, Removal or Weakening of support

Is Third Party Liability (T.P.L) to be included?

This includes Third Party Bodily injury and Third Party Property damage Total Third Party Liability Limit sum insured

Has the Contractor concluded a separate policy for Third Party Liability?

Contractors All Risk Quotation

Personal Details

Period of Insurance

Prinicipal details:

Subcontractor details:

Description of dimensions (in meters):

Special risks:

Details of subsoil

Please provide the following information on the nearest lake, river or ocean:

Please state the amounts you wish to insure and the limits of indemnity required for the following items