UNITED INDIA INSURANCE COMPANY LIMITED
PROPOSAL FOR DETERIORATION OF STOCKS

The liability of the company does not commence until this proposal has been accepted
by the company and the premium paid.
N.B. : If space is insufficient for any answer please continue on a separate sheet and
attach hereto.
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I.1. Proposer :
(a) Name
(b) Postal address
(c) Works address
(location of the cold storage
plant i.e. railway station & district)
2. In the cold storage owned by you or
taken on lease?
3. What are your contractual liabilities
to your customer?
4. How long have you been running the
cold storage?
5. Have you suffered any losses due to
deterioration in the past?
Give details of cause and amount.
II.1. Was the plant insured for machinery
breakdown and deterioration of stocks
previously? If so, please give name
of Insurance Company and period of
Insurance.
2. Was the Insurance at any time
declined by any Company? If so, by
whom and for what reason.
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III. Give the period of Insurance required
by you.
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IV. 1. What would be the maximum stock
of goods stored by you at any
time during the season?
2. State the price per quintal at which
you wish to insure the stock (this
price should include storage charges)
3. Sum to be insured : Rs........
4. Do you maintain any stock register?
If so, please attach a specimen copy
with this form.
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V. 1. Give details of cold storage rooms
number, size, designed storage
capacity.
2. By whom the cold storage is designed?
Give the name of the designer/firm
engineer.
3. (a) Indicate the type of insulation
used in the refrigeration
chambers.
(b) Give cross-sectional sketch of
insulation of all sides.
(c) When was the present insulation
done and by whom?
(d) When was the present insulation
last replaced?
4. Give the design and type of materials
used for storage racks and the name
of firm/engineers who designed,
constructed them.
5. (a) What goods do you store?
(b) Do you accept stocks of high
yielding variety?
(c) Do you ascertain that the stocks offered
for storage are free from disease?
(d) How do you store the goods?
In bags, containers or loose?
(e) Do you sort out bad stocks
before storage?
(f) Do you check for spoilage of
stored goods and arrange for
their removal?
(g) What time will be required to
remove the stocks in case of
breakdown.
(h) In the event of loss, is there
any possibility of storing the
goods in your charge elsewhere?
If so, give full name & address.
(i) Are you authorised to dispose
off the goods stored to avoid
or minimise losses due to
deterioration etc.?
6. (a) What conditions of temperature
(indicate in degree C or F)
and relative humidity do you
maintain in the cold storage
for different goods stored.
(b) How do you ensure proper
circulation of cold air or
proper conditions of temperature
and humidity in the cold rooms?
(c) How do you ensure the proper
loading of cold rooms within
the designed capacity.
(d) At what intervals are the
temperature and humidity
checked?
(e) Is the cold storage plant equipped
with automatic control system? If so,
what is the type of control?
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VI. 1. What is your main source of electric
supply?
Your own generation or from public
grid.
2. State input voltage if power is
obtained from the Public grid.
If a transformer is required for the
input voltage is it located in your
premises and are you the owner?
3. Has the power supply been interrupted
at any time during the last three
years? If so, state number and
duration of interruptions.
4. Do you have stand by arrangement
in the event of failure of main
source of electric supply? If so,
give details.
5. After how many hours (24, 48, 72 or
more) do you expect the stored goods
to deteriorate due to a rise or fall
in temperature in consequence of
machinery breakdown and/or failure
of power supply.
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VII. 1. By whom the machinery has been :
(a) manufactured?
(b) supplied?
(c) erected?
(Give the name of firm/engineers)
2. Give details of :
(a) Refrigerating compressors,
number, make capacity in
tons, bore, stroke, R.P.M.
(b) Are the compressors driven by
electric motors or diesel
engines?
Give details of driving motor
or diesel engine, i.e. H.P.
Serial Number, make, bore,
stroke, R.P.M.,type and voltage.
3. Are there several independent
refrigerating systems and if so,
is it possible to switch from one
to another.
4. Give the number and type of condensor
stands.
5. State the refrigerant used.
6. Give details of circulating water
pumps:
(a) Capacity in gallons per minute
and head in ft/metre.
(b) H.P., R.P.M., type and voltage of
driving motors.
7. Give the number of stand by spare units:
(a) Compressors under loading conditions
(b) Compressors under normal conditions.
(c) Circulating water pumping sets.
(d) Electric motors for diffusers.
(e) Any other equipment.
8. Do you keep a stock of replacement spare
parts for :(Give details)
(a) Compressors.
(b) Driving motors.
(c) Engines.
(d) Pumps etc.
9. (a) Is the plant inspected and
serviced regularly by a
recognised firm of cold storage
specialists or by refrigeration
plant engineer and if so, at
what intervals?
(b) Is the plant under supervision
of a qualified and experienced
refrigeration engineer/
mechanic.
Give name, qualifications,
experience of the engineer,
mechanic-in-charge.
(c) Do you maintain a log book for
the maintenance of plant and
the conditions of temperature and
humidity in the cold rooms? If
so, give a specimen copy of the same.
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VIII. State the date when the Insurance is to
commence. Date..... Month.... Year...
(Period of Insurance will be from the date
till the expiry date).
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I/We HEREBY DECLARE AND WARRANT THAT THE above statements are true and
complete and that I/We have withheld no information whatsoever which is material for
the acceptance of this proposal. I/We agree that this declaration and the answers
given above shall be the basis of contract between me/us and the Company and shall be
deemed to be incorporated in such contract. And that if any untrue statement be
contained therein the said contract shall be absolutely null and void. I/we undertake to
exercise all reasonable and ordinary precautions for the safety of the machinery and
I/We agree to accept the policy in the forms issued by the Company subject to exceptions
the terms and conditions prescribed therein or endorsed on the policy.
Place...........
Date............ Signature.......................