Insurance Logistics Proposal

INSURANCE LOGISTICS PROPOSAL

Applicant / Insured Information

Date of Birth (if individual applicant):

Individual    Corporation    LLC    Partnership    Other (specify):

Operations & Exposure

Brief description of logistics operations (services performed, equipment used, modes of transport):

Primary operating territory (states, regions, international):

Proposed Policy Details

Policy Type (select applicable coverage):
Cargo Insurance (Physical loss or damage)   General Liability   Motor Truck Cargo   Warehouse Legal Liability   Freight Forwarder Liability

Valuation Basis:

Coverage Options & Limits

Risk Basis (select one):   All Risks    Named Perils

Select coverage extensions (check applicable):

Theft & Pilferage    Delay/Contingent Loss    Shortage & Concealment    Contamination & Deterioration    Special Handling / Temperature Control

Sublimits (describe any requested sublimits and amounts):

Exclusions & Limitations

Standard exclusions applicable unless otherwise endorsed (applicant must initial acceptance):

War, hostilities, and terrorism    Wear and tear, gradual deterioration    Packing and inherent vice    Contractual liability beyond policy terms

Requested endorsement or deviation from standard exclusions (if any):

Premium & Quote Summary

Total Amount Due at Inception:

Claims Handling & Conditions

Claims reporting requirements: The insured must notify the insurer in writing within 48 hours of discovery of loss or damage and provide supporting documentation as specified below. Failure to timely report may prejudice coverage.

Subrogation and recovery: The insurer shall have all rights of subrogation against third parties; insured agrees to cooperate with insurer in all recovery efforts and to provide signed subrogation instruments when requested.

Inspection and audit: The insurer reserves the right to inspect premises, records, vehicles, and cargo operations during the policy period and within a reasonable post-loss investigation period.

Documentation Checklist (attach copies)

Please indicate documents attached to support this proposal:

Business registration / articles of incorporation    Operating permits / carrier authorities    Safety inspection certificates    Prior loss runs (past 5 years)    Recent financial statements

Additional supporting notes or explanation of attachments:

Beneficiary / Loss Payee Designation

Designate up to two beneficiaries or loss payees to receive indemnity payments in the event of an insured loss. This designation does not amend policy terms until accepted by the insurer and reflected on the policy declarations.

Declaration & Certification

By signing below, the applicant certifies that the information provided in this proposal is true, complete, and material to the underwriting decision. The applicant acknowledges that any material misrepresentation, omission, or concealment of facts may result in denial of coverage, rescission of the policy, or refusal of a claim. The applicant authorizes the insurer or its representatives to obtain and review underwriting information, loss history, and other relevant records for the purpose of evaluating this proposal.

The applicant understands that this document is a proposal for insurance coverage and does not bind the insurer to provide coverage except to the extent explicitly agreed in writing by an authorized representative of the insurer. Coverage will be governed solely by the policy form and endorsements issued by the insurer and the declarations page.

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