Description Of Packing: Container Shipments: Indicate %'age of your goods shipped in containers % Is cargo shipped in a "door to door" or consolidated container? Yes No Maximum value in container(s): $ Average value in container(s): $ Basis of Valuation - valued at amount of invoice cost. Insurance and any freight at risk plus: % Terms of Sale: (ie. FOB, CIF, etc.): Exports Imports Inland Average Value of Consigment By: Sea $ Air $ Inland $ Maximum Value Shipped: $ by any one vessel or one usual connecting conveyance $ by any one aircraft and usual connecting conveyance $ per shipping package by parcel post $ by any one carrier on North American Inland Shipments Estimated Amount of Yearly Shipments: By Sea $ By Air $ Within Canada/USA $ Duty Insurance Desired On Imports? Yes No Do You Declare The Value Of Shipments To Carriers? Yes No Name of Steamship Lines and/or Airlines Pricipally Used: Countries - To or From Which Shipments are Principally Made: (% by country) Has any Company Ever Cancelled Or Refused Insurance Of This Description? Yes No Premiums and Loss Experience During The Previous Five (5) years: Year Premiums Paid Losses Incurred Comments: CONTACT INFORMATION Contact Name: Phone: Fax: Email Address:
Countries - To or From Which Shipments are Principally Made: (% by country) Has any Company Ever Cancelled Or Refused Insurance Of This Description? Yes No Premiums and Loss Experience During The Previous Five (5) years: Year Premiums Paid Losses Incurred Comments: CONTACT INFORMATION Contact Name: Phone: Fax: Email Address:
Premiums and Loss Experience During The Previous Five (5) years:
Comments:
CONTACT INFORMATION
Contact Name: Phone: Fax: Email Address:
