DRAFT
POLICY SCHEDULE
MARINE CARGO EXPORT INSURANCE 20-3062893
POLICY NO. : Reg. No. : 2003012500094
THE INSURED : CV. BINTANG IKA PERSADA
CORRESPONDENCE ADDRESS : PERUMAHAN GRAHA SURYA MAS BLOK E 18
TEMPEL KABUPATEN SIDOARJO JAWA TIMUR
INDONESIA
TYPE OF COVER (RATE) : Institute Cargo Clause "A" (0.20000 %)
TOTAL SUM INSURED : USD 57,846.00
INTEREST : 4X20GP CONTAINERS SAID TO CONTAIN :
63 PALLETS = 4,583 PIECES = 82.6377 CBM OF
MERBAU E2E AS PER PROFORMA INVOICE
NO.TBA/INV/BIP/XII/2024 DATED 26.12.2024.
INCOTERMS 2020 CIF CHENNAI PORT INDIA
NO. CONTAINER / NO. SEAL :
- SEGU1903598 / SAI 241428
- SEGU3041002 / SAI 241425
- SEGU3036855 / SAI 241427
- CXDU1443154 / SAI 241426
DEDUCTIBLE : - Institute Cargo Clauses A : 1 % of TSI
ATTACHMENT/EXTENSIONS : As per attached
VOYAGE : From : SURABAYA, INDONESIA
Transhipment : Automatically
To : CHENNAI, INDIA
L/C NO. : 0182325FLU000027 DATE : 250116
B/L NO. : IDSUBINMAA25004 DATE : tba
INVOICE NO. : 037INV/BIP/I/2025 DATE : 23 JANUARY 2025
CONSIGNEE NAME : SHRI LAKSHMI WOOD WORKS
133/2B MYSORE MAIN ROAD KENGERI
BANGALORE 560060 KARNATAKA INDIA
KENGERI
IEC CODE NO.: 0708012981
GSTIN NO.: 29AFTPP9614F1ZR
PAN NO.:AFTPP9614F
EMAIL :
[email protected] DATE OF SAILING : 30 January 2025
GRT : 16802
YEAR OF BUILT : 1999
VESSEL NAME : JOANNA 013N
PREMIUM CALCULATION :
- Institute Cargo Clause "A" USD 57,846.00 x 0.2% USD 115.69
TOTAL PREMIUM USD 115.69
Policy Cost USD 1.53
Stamp Duty USD 0.61
KF TOTAL USD 117.83
M20SI0004 Agent Surabaya , 31 January 2025
AGENT / NE_M PT. ASURANSI INTRA ASIA
PSNSI0301E SCAN QR-CODE UNTUK MENGETAHUI KEASLIAN POLIS
{08535A5D-9954-4013-B3BF-44708
96B4AE4}.RPT
DRAFT
This page is a forming part of Policy No.
Attachment / : 1. Sanction and Limitation Exclusion Clause
Extensions 2. Subject to No Overload Cargo During Shipment
3. Sailing Permit From Port Authority ; Seaworthiness / Roadworthiness Warranty
4. Excluding Mysterious Loss and Embezzlement Loss ; Exclude Forwarder`s Liability
5. No Overload Cargo on Board and Passenger ; Standard Packing / Safety Lashing
6. Excluding Scratching, Denting, Bending, Rust, Oxidation
7. Discoloration unless caused by insured perils.
8. Institute War Clauses - 1/1/82
9. Institute Strikes Clauses - 1/1/82
10. Termination of Transit Clause (Terrorism)
11. Institute Cyber Attack Exclusion Clause 10/11/2003
12. Excl. Electronic, Electrical and Mechanical Derangement Unless Caused by Insured Perils
13. JELC Communicable Disease Exclusion - JX2020-009A Clause
14. Nuclear Energy Risks Exclusion Clause 1/1/89
15. Information Technology (IT) Hazard Exclusion Clause JEL 16/11/01
16. Institute Radioactive Contamination, Chemical, Biological, Bio-Chemical, Electromagnetic
Weapons Exclusion Clause 10/11/2003
17. Paramount War Clause (Cargo)
18. Political Risk, Financial Guarantee and Credit Risk Exclusion Clause
19. Extra Contractual Obligation Exclusion Endorsment
20. Warranty / Including Transhipment (If Any) Is Allowed
21. Institute Classification Clause 01/01/2001
22. Loss Notification Clause (14 days)
23. Institute Cargo Clause "A" - 1/1/82
24. Seepage and Pollution Exclusion Clause 1/1/89
25. Warranty Payment Clause (WPC) : 30 Days
PSNSI0301E SCAN QR-CODE UNTUK MENGETAHUI KEASLIAN POLIS
{08535A5D-9954-4013-B3BF-44708
96B4AE4}.RPT
