-Name of insured -Earthquake -Are All areas provided with smoke/heat

-Adress -BushFire detector?

-Trade/Occupation -Vehicular Impact damage -How often is the system tested?
-Risk -BurstPipe -Are maintenance/test records available ?
-Date of Inspection -Aircraft&AerialDeviciesDamage -Is the premises provided with an
-Background/introduction -Lossrecords (in the past 3 years) automatic sprinkler installation?
-Scope of survey If Yes above, kindly give details below -Is the system under insured’s full
-Interest -Circumstance of Loss control?
-Total Sum Assured -Nature of Loss -Are there any boilers/Pressure Vessels
-Adequacy of Sum Assured -Amount of Loss -Is the inspection report in respect of
-Owner (if not the insured/Proposer) Fire Safety Section (kindly give more boiler(s) available?
-Description of Building information on the fire extinguishing -Power Supply
-Type of Building agents at the insured’s disposal) -Details of Electricity Supply
-Building -NumberofFireExtinguisher -Is the risk premises provided with
Number of Separate Building -DetailsofFireExtinguisher security guards
-External Wall Construction -TypeofExtinguishment Agent -Total Number of security guards
-internal Wall Construction -HoseReels -CCTVSurveillance System
-Flooring -Is the hose reel system in operating -Description of
-Roofing condition? Operations/Process/Technologies
-Perimeter Protection -Is there an hose-reel on each floor? -Description of Health, Safety and
-Age Of Building -Is the watertank capacity more than Environment
-Number of Floors 3,600 litres? -Critical
-Occupancy -Hydrant Equipment/Maintenance/Condition
-Neighbourhood -Type of Hydrant Monitoring/Mode of Power
-Remarks -Internal Hydrant -Gas/Fuel Consumption
-Peril exposure -Details of Hydrants -Opinion on the Risk: Underwriters are
-Flood -Risers advised to:
-Storm -Details of Risers -long text
-Fire Sprinkler System -Permit to Work System
-AutomaticAlarmDetector -Ignition Sources
-Description of Storage or Supply Arrangement
-Emergency Response/training
-Description of Loss Prevention Systems and Risk Management Approach
-Observation(s)
-StockRecordKeeping
-Recommandations (faire un écran pour cela)

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