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RAMO DE TRANSPORTES CERTIFICADO DE SEGURO

CERTIFICATE OF INSURANCE
POLIZA/POLICY Nº DEPARTMENT PROJECT: AGENCY

TOMADOR DE SEGURO/POLICY HOLDER:


ADRESS: VAT:

CITY : POSTAL CODE:


BENEFICIARY:

BUQUE O MEDIO TRANSPORTE/VESSEL: VIAJE O TERMINO/VOYAGE:

CONCEPTO VALOR ASEG. % INSURANCE CURRENCY


COVERAGES INSURED VALUE RATE PREMIUM EUR

DATE %/ Cubierta

PACKAGES ENVASES MERCANCIA/GOODS


KING OF PACKAGES
MARKS. Nº

RIESGOS CUBIERTOS/RISKS COVERED


ACCORDING TO THE ENGLISH CLAUSES:
- INSTITUTE CARGO CLAUSES (A) 1.1.2009
- INSTITUTE WAR CLAUSES (CARGO) 1.1.2009
- INSTITUTE WAR CANCELLATION CLAUSE 1.12.1982
- INSTITUTE STRIKES CLAUSES (CARGO) 1.1.2009
- ALL RISK
The Insurer Entity CERTIFIES covering such expedition under the application policy said

In Valencia Day, Month, Yea

Policy Holder / Insured PLUS ULTRA


Compañía de Seguros y Reaseguros,

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