Proposal Form For Comprehensive Insurance (Buildings And Contents) And All Risk PROPOSAL FORM FOR COMPREHENSIVE INSURANCE (BUILDINGS AND CONTENTS) AND “ALL RISKS” Step 1 of 3 33% PERSONAL ADDRESSNameFirstLastPostal AddressStreet AddressAddress Line 2CityZIP / Postal CodePhoneRISK ADDRESSAddressStreet AddressCityZIP / Postal CodeSUMS TO BE INSURED (UNDER-INSURANCE MEANS YOU WILL HAVE TO SHARE LOSSES PROPORTIONATELY ON:)On the buildings of the Private Residence:Boundary Fences/Walls:Swimming Pool/Borehole Motors On Contents therein: PERIOD OF INSURANCE (for a period of one year and renewable annually)From To VALUABLESThe comprehensive policy limits the cover on Gold and Silver Articles, Jewellery and Furs to an amount not exceeding ONE-THIRD of the Contents Sum Insured. If your valuables exceed one- third of the Contents Sum Insured show their total value here . RISK DETAILSType of ResidenceHouseFlat2nd Floor or aboveConstruction Built of brick, stone or concrete, and roofed with slates, tiles, metal, concrete, asbestos or asphaltShow other construction hereOccupation:Used only for private and domestic purposesUnoccupied During daytimeNever unoccupied for more Than 30 days in the year “ALL RISKS” EXTENSION VALUATION CERTIFICATES REQUIRED FOR ARTICLES OVER $ (IGNORE IF INAPPLICABLE)1. Personal Wardrobe (excluding furs)2. Personal Effects (i.e. items generally carried on the person, including Pens, Pencils, Handbags, Wallets (excluding money, stamps, documents, securities, coins, jewellery, Watches and contact lens)(limit any one article 3. Miscellaneous Jewellery (limit any one article 4. Contact LensAny other ItemAny other ItemAny other ItemAny other ItemAny other ItemTotal "All Risks " SUM INSURED(a) Have you had any insurance policy, or proposal, either CANCELLED, WITHDRAWN or DECLINED YesNo If the answer is Yes, give details:CommentsThis field is for validation purposes and should be left unchanged.