Application Form - Forte Insurance
Application Form - Forte Insurance
Application Form - Forte Insurance
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Address(es) : ------------------------------------------------------------------------------------------------------------------<br />
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10. Consulting Name(s) : ------------------------------------------------------------------------------------------------------------------<br />
Engineer<br />
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Address(es) : -----------------------------------------------------------------------------------------------------------------<br />
11. Experience Is the contractor experienced in this type of word or construction methods yes No<br />
\<br />
If yes, please state: -------------------------------------------------------------------------------------------------------------------<br />
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12. Third Party Is third party liability to be included Yes No<br />
If yes. please state the amount : --------------------------------------------------------------------------------------------------<br />
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13. Existing Property Detail of existing buildings or surrounding property possibly affected by the contract words<br />
(excavating, underpinning, pilling, vibrating, ect.) : ---------------------------------------------------------------------------<br />
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Are existing building and/or structures on or adjacent to the site, owned by or held in care,<br />
custody or control of the contractor(s) or the principal to be insured against loss or damage<br />
arising out of or in connection with the contract works Yes No<br />
If yes, please state : ------------------------------------------------------------------------------------------------------------------<br />
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For official use only<br />
Rate :--------------------------------Terms Condition -----------------------------------------------------------------------------------------------------------<br />
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Remarks : -----------------------------------------------------------------------------------------------------------------------------------------------------------------<br />
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Recorded by : --------------------------------------------------
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