Certificate Creator

Insurance

Insurance Certificate Title

Policy No.

Reference

Policyholder or Beneficiary

place of issue

date of issue
Details

Marks / Goods

Voyage

Transportmittel: Truck, Airfreigt, Seafreight, Rail

Sum insured

Currency

Percentage of sum insured

Surveyor to be contacted in case of loss or damage

Surveyor:
Further Information

Insurance Coverage

has been issued in…

Headoffice, claims payment by

Contact

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