Personal Details


Risk Details


General Policy Details

Personal Details

Male Female

Contact Details

Period of Insurance

Building Details

Cold Storage particulars:

Room Details:
Insulation types:

Particulars of Refrigerant facilities:

What is the type of refrigerant used?

Pipes carrying refrigerant are on the?

Who carries out supervision?

Maintenance Carried Out?
Maintenance Carried Out by?
Refrigerating plant details

Control and Alarm systems

State the total number of measuring devices for
What are the check intervals in hours for the following
Alarm is given
Maintenance carried out?

Controlled Atmosphere Storage

Power Supply

Public power supply laid:

Schedule of Goods to be insured

Do you require the following extensions