TYPE : MONEY INSURANCE
(MONEY IN THE PREMISES AND
MONEY IN TRANSIT)
INSURED : PT. _____________ including any and all past,
present or hereafter formed or acquired subsidiary, Affiliated or Allied
companies, corporations, trusts, foundations, entities, trustees, or
organizations which are owned, financially controlled, actively managed or in
which the named Insured has had, or has an interest now or hereafter
constituted of for which the named Insured has assumed the responsibility of
purchasing Insurance.
ADDRESS : to be advised
PERIOD : 12 (Twelve) months from the date to be advised
At 12.00 noon local time (both days
inclusive
LOCATION OF RISK : to be advised
THE BUSINESS : to be advised
OCCUPATION : to be advised
SECTION – I
MONEY IN THE PREMISES :
COVERAGE
|
:
|
Loss of money money orders by any cause whatsoever
in the personal custody of the insured and/or their authorized employees
and/or in the locked safes and/or petty cash and/or whilst in and/or about
the insured premises.
|
Limit of Indemnity
|
:
|
Rp. ………………. And/or equivalent with other
currencies per any one accident
|
Annual Rate
|
:
|
…… %
|
Annual Premium
|
:
|
Rp. ………………….
X …….. % = Rp.
|
----/2
Page : 2
CN No. ….(New/Renewal)
SECTION – II
MONEY IN TRANSIT :
COVERAGE
|
:
|
Loss of money money orders by any cause whatsoever
in the circumstances described in the schedule.
|
Limit of Indemnity
for anyone carrying
|
:
|
Rp. ………………. And/or equivalent with other
currencies per any one accident
|
Estimated
Annual Carrying
|
:
|
Rp. And/or equivalent with
other currencies per any one accident
|
Annual Rate
|
:
|
…… %
|
Annual Premium
|
:
|
Rp. ………………….
X …….. % = Rp.
|
Schedule
|
:
|
(The schedule shall include any
stop over until the final destination)
q From
the Banks to the Insured’s premises and Vice-versa
q From
the Insured’s premises to their Clients’ and/or Suppliers’ and Vice-versa
q From
the Insured’s premises to their other premises and Vice-versa
q In all areas within the plant and
including distribution with the Plant
q Travel
Allowances from Insured’s office to anywhere in Indonesia.
|
Teritorial Limit
|
:
|
Republic of Indonesia
|
“Notwithstanding
of anything in the policy to the contrary, this Policy is extended to cover
dishonesty by the Insured’s Employee subject to being discovered within 72
hours.”
“Both the Insurer and the Insured are entitled
to terminate this insurance upon thirty (30) days notice in writing being
given. Such termination should be effected by the registered letter and the
Insured entitle to a pro-rata refund premium for the un-expired period of
Insurance”.
SECURITY :
Jakarta, _____________, 2002
Sign
in and on behalf of