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  • Policy Schedule Marine Cargo Import Insurance: Reg. No.: 2003022003229

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    Faqih Muhammad
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    This document is a policy schedule for marine cargo import insurance provided to PT. MIWON INDONESIA. It insures 1,250 bags of diatomite product valued at USD 13,125 being shipped from Dalian, China to Surabaya, Indonesia. The policy uses Institute Cargo Clause A at a rate of 0.1% with deductibles of 0.5% of the total sum insured for shortage and other claims. It provides details on the voyage, vessels, interest insured, and attachments to the policy.

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    This document is a policy schedule for marine cargo import insurance provided to PT. MIWON INDONESIA. It insures 1,250 bags of diatomite product valued at USD 13,125 being shipped from Dalian, China to Surabaya, Indonesia. The policy uses Institute Cargo Clause A at a rate of 0.1% with deductibles of 0.5% of the total sum insured for shortage and other claims. It provides details on the voyage, vessels, interest insured, and attachments to the policy.

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    © All Rights Reserved
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    21 views2 pages

    Policy Schedule Marine Cargo Import Insurance: Reg. No.: 2003022003229

    Uploaded by

    Faqih Muhammad
    This document is a policy schedule for marine cargo import insurance provided to PT. MIWON INDONESIA. It insures 1,250 bags of diatomite product valued at USD 13,125 being shipped from Dalian, China to Surabaya, Indonesia. The policy uses Institute Cargo Clause A at a rate of 0.1% with deductibles of 0.5% of the total sum insured for shortage and other claims. It provides details on the voyage, vessels, interest insured, and attachments to the policy.

    Copyright:

    © All Rights Reserved
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    of 2

    POLICY SCHEDULE

    MARINE CARGO IMPORT INSURANCE 20-2243869

    POLICY NO. : Reg. No. : 2003022003229


    THE INSURED : PT. MIWON INDONESIA
    CORRESPONDENCE ADDRESS : JL. PERINTIS KEMERDEKAAN NO. 1-3 RT.7 RW.2
    PULO GADUNG, JAKARTA TIMUR, INDONESIA
    TEL : 62-21-4786-3124 FAX : 62-21-4786-3146
    JAKARTA, 13260
    TYPE OF COVER (RATE) : Institute Cargo Clause "A" (0.10000 %)
    TOTAL SUM INSURED : USD  13,125.00
    INTEREST : - 1250 BAGS A DIATOMITE PRODUCT (FLUX-CALCINED) CELITE 545RV 20KG

    DEDUCTIBLE : - - Shortage : 0.5% Of TSI


    - Others : 0.5% Of TSI

    ATTACHMENT/EXTENSIONS : As per attached


    VOYAGE : From : DALIAN, CHINA
    Transhipment : Automatically
    To : SURABAYA, INDONESIA
    B/L NO. : COAU7226886750 DATE : OCTOBER 20, 2020
    INVOICE NO. : IN00003474 DATE : OCTOBER 20, 2020
    CONSIGNEE NAME : PT. MIWON INDONESIA
    JL. PERINTIS KEMERDEKAAN NO. 1-3
    PULO GADUNG, JAKARTA TIMUR, INDONESIA
    TEL : 62-21-4786-3124 FAX : 62-21-4786-3146
    TIN NO : 01.001.720.0-057.000
    CONSIGNEE ADDRESS : PT. MIWON INDONESIA
    JALAN RAYA DRIYOREJO KM.24
    KEC. DRIYOREJO - KAB. GRESIK 61177,
    JAWA TIMUR - INDONESIA
    TEL:62-31-750-7888 FAX:62-31-750-7595
    TIN NO : 01.001.720.0-057.000
    DATE OF SAILING : 20 October, 2020
    GRT : 194864
    YEAR OF BUILT : 2018
    VESSEL NAME : COSCO SHIPPING GEMINI 013W
    NOTE : - Excluding Scratching, Denting, Bending, Rust, Oxidation and Discoloration, etc
    Except Caused by Insured Perils.
    - Excl. Electronic, Electrical and Mechanical Derangement Unless Caused by
    Insured Perils.
    - As Per MOCP No. : MC-06/MCOP/X/2020
    - WPC : 30 Days
    PREMIUM CALCULATION :
    - Institute Cargo Clause "A" MINIMUM PREMIUM USD  13.60
    TOTAL PREMIUM USD  13.60
    Policy Cost USD  1.70
    Stamp Duty USD  0.41
    TOTAL USD  15.71
    FQ Surabaya , 20 October 2020
    M20SE0001 Agent PT. ASURANSI INTRA ASIA
    DIRECT / SE

    PSNSI0301E.RPT AHEEEHAPCMJJBJCCIBIILOOBGMLMP Page 1 of 2


    CGIJPPEMALIBPAHEEEHA
    BNFFFNBPMPBKBPBKFCEPEOAHFHAP
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    This page is a forming part of Policy No.

    Attachment / : 1. Sailing Permit From Port Authority ; Seaworthiness Warranty.


    Extensions 2. Institute Radioactive Contamination, Chemical, Biological, Bio-Chemical, Electromagnetic
    Weapons Exclusion Clause 10/11/2003 and Institute Cyber Attack Exclusion Clause 10/11/2003

    3. Excluding Mysterious Loss and Embezzlement Loss ; Exclude Forwarder`s Liability.


    4. Subject to No Overload Cargo During Shipment ; Sanction and Limitation Exclusion Clause.
    5. Institute Classification Clause 01/01/2001
    6. Termination of Transit Clause (Terrorism) ; Paramount War Clause (Cargo)
    7. No Overload Cargo on Board and Passenger ; Standard Packing / Safety Lashing.
    8. Extra Contractual Obligations Exclsuion Endorsement
    9. Political Risk, Financial Guarantee and Credit Risk Exclusion Clause
    10. Institute Cargo Clause (A) 1.1.82

    PSNSI0301E.RPT AHEEEHAPCMJJBJCCIBIILOOBGMLMP Page 2 of 2


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