现金保险投保书
MONEY INSURANCE PROPOSAL

请如实详细回答下列所有问题
Please ensure that all questions are answered fully and accurately.

投保人(全称)
Name of Proposer in full ______________________________________________________________________

营业性质
Nature of Business ___________________________________________________________________________

地址
Address ____________________________________________________________________________________

电话号码 传真号码
Telephone Number / Fax Number _______________________________________________________________

被保险人营业执照的注册地址是否在浦东？
Is the registered address on the Assured's Business License in Pudong? 是Yes 否No

保险期限 　　　　　　从 　　　　　　　　　　　　　　　　至
Period of Insurance From ______________________________ To ________________________________

1. 投保的现金或钞票
Cash and / or Bank Notes to be covered
每次在途最大现金额額 预计年在途现金总额
Maximum amount in transit Estimated total amount
at any time in transit in the year

a) 从银行提取的工资/薪水
Wages and salaries drawn from the bank
b) 从银行提取的工资/薪水以外的其它现金/钞票
Cash and / or Bank Notes drawn from the
bank other than wages and salaries
c) 运送往银行的现金/钞票
Cash and / or Bank Notes conveyed to the bank
d) 存放在保险箱内的现金/钞票
Cash and / or Bank Notes kept in locked safe

注:您所填写的每次在途最大现金额是本公司所承担的每次损失的最大责任限额額
Note: The amount given as the maximum amount in transit at any time will be the limit of the Company's Liability in respect of any one loss.

2. a) 银行地址及到您的营业场所的距离
Address of Bank and distance from your premises

___________________________________________________________________________________________
b) 使用何种运输方式?
What mode of transport is used?

___________________________________________________________________________________________
3. 多少人参与
How many persons are engaged in
a) 从银行提取现金/钞票
conveying cash and/ or bank notes from the Bank a)
b) 到银行存入现金/钞票
conveying cash and/ or bank notes to the Bank b)
对于a)和b), 如何使用专用保管箱
In case of a) & b), How to hand secure box
c) 支付工资及收付现金
paying the wages and handling money c)

4. 如果现金/钞票在公司过夜,请说明
If the cash and / or bank notes are retained overnight please state
a) 保险箱的体积
dimensions of safe a)
a) 制造商
name of maker b)
b) 购买日期
date of purchase c)
c) 钥匙数目和由谁保管
number of keys and by whom held d)
d) 安全警报/系统
security alarms/systems e)

5. 现金在工作日是如何存放的? 会计部/出纳办公室通常是否上锁?
How is money held during the working day? Is Accounts Dept./Cashiers office always locked?

______________________________________________________________________________________

6. 贵公司是否曾遭受过现金/钞票的损失? 若是,请详述细节
Have you ever sustained a loss of cash and /or bank notes? If so, please give particulars

______________________________________________________________________________________

7. 贵公司是否曾购买过此类保险? 如果有,请写明保险公司名称
Have you previously insured against this risk? If so, state name of insurers.

______________________________________________________________________________________

声明事项 Declaration
我们声明根据我们所知及所信在本投保书内填报的资料为真实的,且所有会影响风险评估的细节均已填报。如隐瞒任何重要事实,均可导致本保险单失效。我们同意将本投保书及声明事项作为我们与皇家太阳联合保险公司订立保险合约的基础。
We declare the information given is true to the best of our knowledge and belief and that all particulars affecting the assessment of risk have been disclosed. Failure to disclose all material information could invalidate the insurance. We further agree that this proposal and declaration shall be the basis of the contract between us and the Company.

投保人签名 日期
Signature of Proposer __________________ Date__________________

以下仅供保险公司使用 Insurers Use Only
Occupation ____________________ U/W Category ________________ EML_____________________

Within Underwriting Authority Yes No

Gross Rate __________________ Gross Premium ________________ Deductible ________________

本投保书需经保险人正式接纳或正式的暂保单签发后,保险人的保险责任才正式生效。
The liability of the Insurers does not begin until the Proposal has been formally accepted by the Insurers or official cover note issued.