新華保險顧問有限公司
Sun Flower Insurance Brokers Limited
香港專業保險經紀協會會員
A MEMBER OF PROFESSIONAL INSURANCE BROKERS ASSOCIATION
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電話Phone
電子郵件E-mail
日期Date

辦公室綜合保險報價申請表

OFFICE INSURANCE REQUEST FORM

辦公室專用 For Office Use Only
項目
Section		 保障範圍
Cover 		投保額
Sum Insured (HK$) 		保費率
Rate 		保費
Premium
1 辦公室財物全險 Office Contents “All Risks” Insurance
A. Office Contents
(如其中投保之辦公室器材價值超過HK$100,000，請列明 Please list any item of office machinery where the value exceed HK$100,000)
B. 貨版及存貨 Trade Sample or Stock
每件最高價值 Max. Limit per article ()
2 營業中斷保險  Business Interruption Insurance 500,000 免費 Free Cover
A. 額外開支   Increased Cost of Working
B. 收入損失      -Loss of Gross Income for next 12 months
           -Max indemnity period required 12/18/24 M
3 金錢損失保險    Loss of Money Insurance 參閱小冊子as per brochure 免費 Free Cover
4 公眾責任保險    Public Liability Insurance 10,000,000 免費 Free Cover
 最低保費 Min.
5 僱員賠償保險    Employees’ Compensation Insurance (自選保障 Optional Cover)
*如僱員需要前往海外或中國大陸工作，請列明於「海外公幹備註」Please remark employees required to travel “Overseas” or “China”
**「預計全年總收入」須包括佣金 / 花紅 / 雙糧 / 津貼等 “The Estimated Annual Total Earnings” has to include commission / bonus / double pay / allowance etc.
項目
Item		 僱員人數及工作類別
No. & Description of Employee 		海外公幹
備註*
Remark 		預計全年總收入**
Estimated Annual Total
Earnings (HK$) 		條款
Warranty 		保費率
Rate 		保費
Premium
1.
2.
3.
4.
5.
小計Total  最低保費Min.
賠償記錄 Claims History

過往三年有否索償 Any Claim in the past 3 years?   有Yes   否No

勞 保 徵 費 Levy 10.8%
總保費Total Premi um
佣金 Comm. %
淨保費Net Premiu m
附加文件 Supplementary Document - 請提供閣下最新的續保通知書或保險單副本作核保用途
Please provide copy of latest renewal notice or policy schedule for underwriting purpose