MONEY INSURANCE PROPOSAL FORM
1.
Contact Information
Name of Proposer
Contact Name (inc Title)
Business/Occupation
Premises where safe is kept ?
Current Address:
Contact Phone
Fax
P.O.Box
Address
2.
Describe fully Money in transit to be Insured
The expression “MONEY” means Cash, Bank Notes, Cheques, Money Orders, Postal Orders, Bills of Exchange and Postage and other Stamps having a monetary value.
(a)
Limit of Liability Maximum amount carried any one Time
Cash
Cheques
Estimated Annual Carrying
Maximum distance involved in transit
Maximum Amount Retained In Locked Safe (if none, state "NIL")
If wages and salaries are not paid away on the day drawn from the Bank,state maximum amount of such moneys held in locked safe or strong room out of business hours
maximum period kept in locked safe
Remarks.............
Premises to Bank
Money other than (a) above in transit from premises to Bank or other places and vice versa,
(please specify)