机器损坏险保险合同

　　1.机器损坏险投保单

　　machinery breakdown insurance application

　　保单号

　　policy no.

　　本投保单由投保人尽可能如实地、详细地填写并签章后作为向本公司投保机器损坏险的

　　依据。本投保单为该机器损坏险保险单的组成部分。

　　the applicant is required to fill in the following items with utmost faith and as detailed as pos-

　　sible. and affix signature to this application, which shall be the basis of application to the company

　　for machinery breakdown insurance and constitute an integral part of the machinery breakdown in-

　　surance policy.

　　--------------------------------------------

　　1.被保险人名称和地址name and address of the insured: |

　　-------------------------------------------|

　　2.营业性质nature of business: |

　　-------------------------------------------|

　　3.被保险机器所在地location of machinery to be insured: |

　　-------------------------------------------|

　　4.保险期限: 个月, 年