טופס ביטוח יהלומים – טופס הצעה להורדה, הדפסה ומילוי מקוון

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טופס ביטוח יהלומים – טופס הצעה להדפסה

מה זה טופס ביטוח יהלומים - טופס הצעה?

Form Name: Jewellers' Block Policy - Israel

Purpose of the Form: This form is a proposal form for a Jewellers' Block Policy in Israel. The form is designed for businesses in the jewelry industry to provide information to the insurer for the purpose of obtaining insurance coverage.

Sections and Questions in the Form:

1. Details of the Proposer: This section requests information about the proposer and their business, including the name, address, names of principals, and the duration of the business at the current premises.

2. Nature of Your Business: Asks about the nature of the business, whether it's manufacturing, merchant, wholesale, retail, or other.

3. Employees: Inquires about the number of employees in the business.

4. Valuation Basis: Asks how the proposer wants claims to be settled based on the valuation of goods.

5. Insurance Background: Seeks information about any loss sustained in the last 5 years and any history of insurance cancellations or refusals.

6. Protections: Inquires about the security measures in place, including alarm systems, safes, closed-circuit TV, and other means of protection.

7. Sum Insured: Asks for the maximum amounts to be insured in various categories, including stock in premises, goods outside of safes during non-business hours, entrustments to others, carryings outside premises, home risks, safe deposit vaults, and other categories.

8. Deductible: Asks for the deductible amount to be borne by the assured in case of a loss.

9. General Information: Asks about the frequency of stocktaking, requests references from the trade, and inquires about any undisclosed circumstances affecting the proposed insurance.

10. Extension – Sendings: This section is for proposers who want to purchase additional coverage for import/export sendings. It asks for details about the maximum amounts to be insured and the basis of valuation.

11. Extension – On Tours: This section is for proposers who want to purchase additional coverage for outdoor carrying overseas. It asks for details about the persons carrying goods, countries involved, sum insured, and the number of days per year.

At the end of the form, there is a statement indicating that signing the form does not bind insurers to accept the insurance, and it must be signed by the proposer.

Form Provider: Clal Diamond Insurance Agency (1988) Ltd, located on Bazel Street in Israel.

Please note that this summary is a concise overview of the form's content and purpose. The actual form may contain additional legal and technical details that are not included in this summary.

טופס ביטוח יהלומים - טופס הצעה חלופה נגישה - כרגע לא קיימת.

טופס ביטוח יהלומים - טופס הצעה מילוי מקוון - כרגע לא קיים.

טופס ביטוח יהלומים - טופס הצעה הזמנת טופס בדואר - כרגע לא קיימת אופציה.

טופס ביטוח יהלומים - טופס הצעה להורדה והדפסה - טופס PDF זמין במעלה העמוד.

הגרסה הנגישה של הטופס (טקסט בלבד):

כלל יהלומים סוכנות לביטוח (1988 (בע"מ
Clal Diamond Insurance Agency (1988) Ltd
בורסת היהלומי, רח' בצלאל 52 ר"ג 52520 בני נוע 106
Int 2 - 6216 : 97235751034 Fax 97235751451 Tel :
Proposal Form
Jewellers' Block Policy - Israel
Please reply fully to ALL following questions
If the answer to any question is none, please state "NONE"
Please make sure you fully understand each question before replying.
Page 1 out of 5
QUESTIONS ANSWERS
Question no. 1 – Details of the proposer
(a) Name of the proposer and all subsidiary and/or
affiliated companies (in full):
(b) Address of the premises to which the Policy is
to apply:
(c) Names of all principals of the proposer:
(d) How long have you carried on business: (a) In these premises: ___________
(b) Elsewhere: __________
Question no. 2 – Nature of your business
What is the nature of your business: Manufacturing, Merchant, Wholesale, Retail
Other: ______________
Question no. 3 – Employees
How many employees do you have:
• Question no. 4 - Valuation basis
On what basis do you require claims to be settled: Own goods – cost price
Entrustments by you – cost price
Entrustments to you – memo price
On Tours – cost price or memo, as above
Sendings – invoice value כלל יהלומים סוכנות לביטוח (1988 (בע"מ
Clal Diamond Insurance Agency (1988) Ltd
בורסת היהלומי, רח' בצלאל 52 ר"ג 52520 בני נוע 106
Int 2 - 6216 : 97235751034 Fax 97235751451 Tel :
Page 2 out of 5
Question no. 5 – Insurance Background
(a) Have you (including any of your principals)
sustained any loss or losses during the last 5
years?
If so – please provide details, including the
amounts of each loss, and if insured, whether
paid in full or otherwise:
(b.1) Has any insurer ever cancelled or refused to (b.1)
issue or continue any insurance for you:
(b.2) Have you previously been insured. If so – (b.2)
state with whom:
Question no. 6 - Protections
(Always subject to survey recommendations)
(a) Alarm system: (a) Office: _____________________
Factory: ____________________

(b) Safes (please provide full details, (b) Office: _____________________
including weight, locks, if concreted, etc.): Factory: ____________________
(c) Are all keys (including your alarm, safe (c) Office: _____________________
and strong room keys) removed from the Factory: ____________________
premises when unattended):
(d) Closed circuit TV: (d) Office: _____________________
Factory: ____________________
(e) Civil security services: (e) Office: _____________________
Factory: ____________________
(f) Other means of protection: (f) Office: _____________________
Factory: ____________________
Or – as per survey report by _______________
Dated ___________. כלל יהלומים סוכנות לביטוח (1988 (בע"מ
Clal Diamond Insurance Agency (1988) Ltd
בורסת היהלומי, רח' בצלאל 52 ר"ג 52520 בני נוע 106
Int 2 - 6216 : 97235751034 Fax 97235751451 Tel :
Page 3 out of 5
Question no. 7 – Sum insured
(Note: the sums insured are subject to Insurers' approval and are always subject to the policy
terms and consitions and to the survey recommendations)
What are the maximum amounts you require to be insured in each of the following categories:
(a.1) Stock in premises: (a.1)
(1) Office in DEC: __________
(2) Factory: _______________
(state address:
___________________________)
(3) Elsewhere: _____________
(state address:
___________________________)
(a.2) Goods out of safe when the premises are (a.2) ________________
unattended outside business hours:
(b) Entrustments to others:
(b.1) Any one entrustee (dealer, customer, (b.1)
repaireman, processor or broker): (1) Within DEC: _____________
(2) All over Israel: ___________
Names of entrustees:
_________________
_________________
_________________
_________________
(b.2) What form of acknowledgement do you (b.2) __________________
receive from entrustees (commission notes, ___________________
delivery notes, memo notes etc.):
(c) Carryings outside premises (including to and Within DEC: ____________
from banks or safe deposits) by yourselves,
your representatives, travellers, agents,
messengers, but NOT brokers: All over Israel: ____________
(d) Home risks – any principal, employee, traveller or agent taking stock to his private residence for
any purspose:
Name Address Maximum value Full details of safe, alarm
taken or other protection
(e) Safe deposit vault: (e.1) In premises: ____________
(e.2) In DEC vault and/or in DEC banks:
____________
(f) F.F.&F.: ______________ כלל יהלומים סוכנות לביטוח (1988 (בע"מ
Clal Diamond Insurance Agency (1988) Ltd
בורסת היהלומי, רח' בצלאל 52 ר"ג 52520 בני נוע 106
Int 2 - 6216 : 97235751034 Fax 97235751451 Tel :
Page 4 out of 5
(g) Cash and bank notes: ______________
(h) Earthquake ______________
(i) Other: _____________ ______________
_____________ ______________

Question no. 8 – Deductible
Deductible amount to be borne by the Assured in $______, but in respect of misterious
respect of each loss: disappearance: $_______.
Question no. 9 - General Information
(a) How often do you take stock taking:
(b) Unless proposing for renewal, give two
references from your trade:
(c) Are there any other circumstances within your
knowledge or opinion not already disclosed,
affecting or likely to affect the proposed
insurance:
Please Note:
Signing this form does not bind Insurers to accept the insurance.
I/we are authorized to sign this proposal on behalf of the proposer and agree that all information
included in this proposal shall be the basis of the contract should a policy be issued.
I/we have read the above and agree that to the best of my/our knowledge and belief, it represents a true
and complete statement.
I/we agree that if this insurance is completed, the protections and/or safeguards mentioned above shall
not be withdrawn or varied to the detriment of the interest of CLAL INSURANCE COMPANY LTD.
without their consent.
Signature of the proposer: Date: כלל יהלומים סוכנות לביטוח (1988 (בע"מ
Clal Diamond Insurance Agency (1988) Ltd
בורסת היהלומי, רח' בצלאל 52 ר"ג 52520 בני נוע 106
Int 2 - 6216 : 97235751034 Fax 97235751451 Tel :
NOTE: The following questions should only be answered in case the proposer requsts to
purchase the following Extension(s) in addition to the Jewellers' Block policy.
The answers hereunder, together with the answers provided by the proposer in the
previous sections of this proposal shall be deemed a single proposal form
EXTENSION – SENDINGS
Import/Export
(Subject to the Sendings Certificate)
(Please note that you must notify Insurers in writing prior to each sending)
(a) What are the maximum amounts you
require to be insured in each of the
following categories:
(a.1) Secured/controlled sendings: (a.1) ____________
(Malca Amit, Brinks, Ferrari) (maximum per parcel - $1 million)
(a.2) UPS/Fedex/DHL/Registered Mail/EMS: (a.2) ____________
(maximum per parcel - $10,000)

(a.3) Personal conveyance: (a.3) ____________
(Always subject to the Close Personal (maximum - $500,000)
Custody and Control Clause)
(b) What is your maximum expected turnover in (b) ______________
respect of sendings:

(c) What is the basis of valuation: (c) Invoice value
or as otherwise agreed: ________________
EXTENSION – ON TOURS
Outdoor Carrying Overseas
(subject to the On Tours Certificate)
Requested Cover:
(a)Names of persons carrying goods: (a)______________
______________
______________

(b) Countries: (b) U.S.A., Western Europe, Far East
(excluding the French Riviera and Italy –
south of Rome)
(c) Sum insured: (c) ______________
(d) Number of days per year: (d) ______________
Please Note: Signing this form does not bind Insurers to accept the insurance.
I/we are authorized to sign this proposal on behalf of the proposer and agree that all information
included in this proposal shall be the basis of the contract should a policy be issued. I/we have read the
above and agree that to the best of my/our knowledge and belief, it represents a true and complete
statement.
Signature of the proposer: Date:
Page 5 out of 5

קרא עוד

מה תמיד שואלים לפני שממלאים טופס ביטוח יהלומים - טופס הצעה?

רשמנו עבורך מדריך מפורט שעונה בדיוק על השאלה הזו וכמובן גם עוזר במילוי טופס ביטוח יהלומים – טופס הצעה, אנו ממליצים לקרוא את המדריך מתחילתו ועד סופו והדברים יהיו ברורים יותר.
בתחילת המדריך צירפנו עבורך קישור להורדת טופס ביטוח יהלומים – טופס הצעה. יש ללחוץ על הכפתור ואתה תעבור להורדת הטופס. במידה והינך גולש ממכשיר סלולרי או אייפון לדוגמא שלא מתחיל את ההורדה בצורה מיידית, תוכל לגלול מטה במאמר אל הטופס לצפייה ישירה ולהוריד אותו משם אל המכשיר.
בכל מדריך אנו מצרפים את הגורמים הרלוונטיים אשר יכולים לסייע לכם במילוי הטופס המדובר, ניתן לקרוא במדריך ולקבל את הטלפונים והמיילים של הלשכות הרלוונטיות לסיוע במילוי טופס ביטוח יהלומים – טופס הצעה.

גוף שיתמוך בשאלות על טופס ביטוח יהלומים - טופס הצעה

פקס: 077-6383290
כתובת לשליחת מכתבים: ת.ד. 37070 תל אביב 6136902
עורכי האתר "טופס קל"
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*לידיעתכם: האתר טופס קל הוא פורטל טפסים פרטי ואינו קשור בשום צורה לגופים ממשלתיים כאלו או אחרים. המידע מוגש לטובת הציבור אך עלולות ליפול טעויות במידע או שהמידע המוצג עלול להיות לא מעודכן ולכן אין להסתמך על המידע בצורה מוחלטת אלא יש לבדוק את הטפסים בטרם שליחתם עם הגופים המנפיקים.

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