APPLICATION FOR ALL RISK PROTECTION COVER

Lump Sum Protection Cover

Title
First Name
Last Name
Packing Date
Owner Packed
Professionally Packed
Mode of Transport
Moving from City and Country  
Moving to City and Country  
   
Please read the below important remarks for the Lump Sum Protection coverage:
  1. The chargeable scale is based on cubic meter (i.e. CBM). One (1) cubic meter is equivalent to 35.32 cubic feet
  2.  Each cubic meter of goods is given a fixed value at the minimum of EUR 2500 (or equivalent in other currencies). You may declare at a higher value if required but cannot declare at the value less than EUR2500/cubic meter.
  3. Minimum volume is at one (1) cubic meter (or EUR 2500).
  4. Any item or set valued more than EUR 1500 (or equivalent in other currencies) must be separately listed and are in addition to the minimum EUR 2500 per cubic meter calculation.
  5. Final chargeable scale will be based on the actual measurement of the shipment after packing and crating has been completed
Note: Please do not delete the zeros unless these are being replaced with a value

LUMP SUM PROTECTION COVERAGE
(A) Total Cubic Capacity of your shipment

(One cubic meter is equivalent to 35.32 cuft)
(B)  @ EUR 2500 per cubic meter
Plus the total of any items valued in excess of EUR 1500 as listed on this inventory
QTY Article  Unit Value Total Value  
 
 
 
 
 
 
Total Household Goods
Automobile
Shipping Costs
Grand Total
   

      Terms & Conditions
      

Please click here to confirm that you have read and agree to the terms and conditions

Declaration of the Proposer

I declare that I have disclosed all material facts and understand that failure to do so could render my enrolment and coverage void. I declare that the amounts stated above are the full value of the goods at destination. I confirm that I have declared all items that I wish to be covered with all details requested. I have read the conditions stated overleaf and understand that these shall form the basis of my enrolment in the All Risk Protection Group Policy.

 

Please select a Santa Fe office you want to submit this form to

Note: This should be the office you have booked your relocation with.

 

I want to receive a copy of my enrolment form

 

Please specify email:

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