Decennial Liability Proposal for Foreign Contractors.pdf


Aperçu du fichier PDF decennial-liability-proposal-for-foreign-contractors.pdf

Page 1 2 34515


Aperçu texte


3

Decennial Liability Proposal for Foreign Contractors
Insurance Company currently on cover

Name:
Claims (last 5 years):
Claims

Type

Cost

Claim 1



Claim 2



Claim 3



Is the Policy still active?

YES

Comments

NO

If yes, please indicate the name of the insurer and the limit of indemnity:

If no, give the reason:

Company information

Do you employ or delegate work to subcontractors?

YES

NO

If so, list the subcontractors and the type of work:
Name

Activities

Value of Contract

Decennial Liability
Company:
Policy Number:
Value of Works:
Company:
Policy Number:
Value of Works:
Company:
Policy Number:
Value of Works: