Aman Insurance Company

Request For Marine Insurance

Owner Name Insured Tel

Email Fax

Address

Bank: Branch:

.L/C. NO:

مبلغ التأمين: Plus Rate Of Exch

Description of Goods

Voyage(s):From To: Via:

Transhipment at:

Conveyance(s)

Date of Shipment:

Note: If goods are shipped by air, the value of the land carrier must be declared

Conditions

(A) Clauses Only

War & SRCC Premium

Land Tranit ( limited cover )

Land Tranit ( Extended cover )

(B) Clauses Only

War in land Transet