household-goods-in-transit2

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					Full name of owner of the household goods & personal effects:-


…………………………………………………………………..…………….……………………….……

2.     Address from which goods are to be moved
       …………………………………………………………

3.    Date on which goods are to be
moved…………………………………………………………………..

4.     Mode of removal - Ship, Rail, Road or
       Air……………………………………………………………….

5.     Name of Contractor/Clearing & Forwarding
       Agent……………………………………………………..


……………………………………………………………………………………………………………….

6.     Address to which goods are to be
       moved………………………………..……………………………..


………………………………………………………………………………………………………….……

7.     Estimated date of arrival of
       goods…………………………………………….………………………….

8.     Will goods be owner or professionally
       packed………………………………………………………....
..
9.     Will goods be containerised / Breakbulk /
       Crated…………………………….……………….……….

10.    Premium Rate & Premium
       amount………………………………………………………………….…..

11.    Excess/es……………………………………………………………………………………………
       ..……

Give estimated NEW REPLACEMENT values at place of destination for the
following………………………

       a)      Non-breakables                                    R _________________

       b)      Furniture & household goods                       R _________________

       c)      Glassware & China                                 R _________________

       d)      Antiques (to be agreed)                           R _________________

        e)     Radios, refrigerators, stoves                     R _________________
               and any other electrical appliances
TOTAL as per valued inventory detailed below:                 R _________________




                     LOUNGE :                                      DINNING ROOM :
 Furniture                        R             Furniture                      R
 Loose Lamps                      R             Loose carpets                  R
 China & Glassware                R             Curtains & Fittings            R
 Silverware                       R             China & Glassware              R
 Television                       R             Silverware                     R
 Hi-fi & Records                  R             Cutlery & Tableware            R
 Radio/Tape Deck/Tape             R             Pictures & Ornaments           R
 Piano                            R             Lamps & Electrical Fittings    R
 Pictures & Ornaments             R             Liquor                         R
 Lamps & Electrical Fittings      R             Appliances                     R
 Miscellaneous                    R             Miscellaneous                  R
                       STUDY :                                      FAMILY ROOM :
 Furniture                        R             Furniture                      R
 Loose carpets                    R             Loose carpets                  R
 Curtains & Fittings              R             Curtains & Fittings            R
 Lamps & Electrical Fittings      R             China & Glassware              R
 Books                            R             Silverware                     R
 Pictures & Ornaments             R             Television                     R
 Hi-fi & Records                  R             Hi-fi & Records                R
 Radio/Tape Deck/Tape             R             Radio/Tape Deck/Tape           R
 Television                       R             Piano                          R
                                                Pictures & Ornaments           R
 Video Machine                     R            Lamps & Electrical Fittings    R
 Computer, Printer, Fax/Related    R            Miscellaneous                  R
                  KITCHEN / PANTRY:                                ALL BEDROOMS:
 Furniture                         R            Furniture                      R
 Refrigerator/Contents             R            Loose carpets                  R
 Deep Freeze/Contents              R            Curtains & Fittings            R
 Cooker                            R            Bedding                        R
 Dish Washer                       R            Clothing                       R
 Electrical Fittings               R            Lamps & Electrical Fittings    R
 Cutlery                           R            Pictures & Ornaments           R
 China & Glassware                 R            Jewellery                      R
 Cooking utensils                  R            Miscellaneous                  R
 Curtains & Fittings               R                              LINEN CUPBOARD:
 Food mixer                        R            Clothing                       R
 Food                              R            Household Linen                R
 Miscellaneous                     R            Miscellaneous                  R
                     HALL / PORCH:                                    LAUNDRY:
 Furniture                         R            Curtains & Fittings            R
 Loose Carpets                     R            Washing Machine                R
 Curtains & Fittings               R            Ironing Machine                R
 Lamps & Electrical Fittings       R            Iron/s                         R
 Pictures & Ornaments              R            Electrical Fittings            R
 Miscellaneous                     R            Miscellaneous                  R
                      BATHROOM:                                         LOFT:
 Furniture                           R                    Furniture                           R
 Floor Covering                      R                    Trunks etc.                         R
 Curtains & Fittings                 R                    Miscellaneous                       R
 Electrical Fittings                 R                                         GARAGE:
 Miscellaneous                       R     Electrical Fittings                                R
                TOOL SHED:                 Battery Charges                                    R
 Lawn Mower                R               Bicycles                                           R
 Garden Tools              R               Tools                                              R
 General Tools             R               Miscellaneous                                      R
 OTHER / SPECIFY :    R                    R                                           R
                        TOTAL RE ALL above :                                                  R




I, the undersigned hereby confirm I have read & fully understand cover applicable
in respect of the transit risk of my household goods & personal effects




Signed by                (signature of owner) &                       (date)




                       ( Please refer to quote re whether cover 1 , 2 or 3 to apply )

                  HOUSEHOLD GOODS AND PERSONAL EFFECTS CLAUSE HGPE1


1.      COVER 1

        This insurance is against All Risks in terms of the Institute Cargo Clauses (A) or Institute Cargo
        Clauses (Air) so far as may be applicable and the Institute Replacement Clause.

        This insurance includes the risks or War and Strikes in terms of the relative Institute Clauses.

2.      EXCLUSIONS (in addition to those contained in the Institute Cargo Clauses as above)

        a)        Gradual deterioration, moths, vermin, rust, mildew, any process of cleaning or repair.

        b)        Mechanical, electrical or electronic derangement unless actual breakage has occurred or
                  other than as a direct result of fire, derailment, collision or overturning of the Conveying
                  Vehicle or fire, stranding or collision of the Vessel.

        c)        Consequential loss of any kind.

        d)        Depreciation resultant upon repairs for under this insurance.

        e)        Detention from any cause or confiscation by Customs officials.

        f)        Foodstuffs, cash, banknotes, stamps, securities or documents of value.
         g)       Containers other than suitcases or trunks properly cased.

3.       DURATION OF COVER

         Clauses 8.1 to 8.1.3 of the Institute Cargo Clauses (A) and Clauses 5.1 to 5.1.3 of the Institute Cargo
         Clauses (Air) are deemed to be deleted and replaced by the following:

         The insurance attaches from the time the goods leave the warehouse, place of storage or Insured's
         domicile at the place named herein for the commencement of the transit and continues whilst at
         packers premises during the ordinary course of transit and terminates either:

         a)       On delivery to the Insured's domicile at the destination named herein.

         b)       On delivery to any warehouse or place of storage whether prior to or at the destination which
the
                  Insured elects to use for storage other than in the ordinary course of transit whichever shall
first
                  occur.

4.       WARRANTED that all the goods hereby insured are professionally packed




3.       Warranted that the total value of china, glassware, marble, earthenware and similar brittle articles and
         of antique furniture does not exceed 15% (fifteen per cent) of the total sum insured unless otherwise
         recorded by endorsement to this policy.

4.       WARRANTED that refrigerators, deep-freezers, washing machines, tumble driers, dish-washers,
         record-players and/or other appliances to be properly prepared for transit and that refrigerators and
         deep-freezers to be dry, defrosted and emptied prior to commencement of the transit.

6.       If the property covered by this insurance shall at the time of any loss or damage be of greater value
than the as the sum insured by this policy bears to the total value of the said property.

7.       In the event of loss of and/or damage to any articles forming part of a pair or set, the Insurer's liability
         shall be limited to the value of such part or parts which may be lost or damaged, without reference to
         any special value which such articles shall have as part of such pair or set, nor shall it exceed toe
         proportionate part of the insured value of such pair or set.

8.       In the event of damage to any article or any part thereof in respect of which there is a valid claim, the
         Insurers shall have the option of paying for the amount of the damage or having the article - repaired
         or replaced in a reasonable sufficient manner.

9.       In the event of damage to any article or any part thereof in respect of which there is a valid claim, the
         Company shall have the option of paying for the amount of the damage or having the article repaired
         or replaced in a reasonably sufficient manner.

10.      If this policy covers the insured goods from the Insured’s domicile, the risk commences from the time
         the insured goods leave the Insured’s residence at the place named in the policy for the
         commencement of the transit and continues at packers’ premises during the ordinary course of
         packing and thereafter during the ordinary course of transit until delivery at the place of destination
         named in the policy.
     ( Please refer to quote re whether cover 1 , 2 or 3 to apply )
                                                      OR

      HOUSEHOLD GOODS AND PERSONAL EFFECTS CLAUSE - HGPE2                                   (EXCLUDING
                               BREAKAGE)

1.      COVER 2

        This insurance is against All Risks in terms of the Institute Cargo Clauses (A) or Institute Cargo
        Clauses (Air) so far as may be applicable and the Institute Replacement Clause.

        This insurance includes the risks of War and Strikes in terms of the relative Institute Clauses.

2.      EXCLUSIONS: (In addition to those contained in the Institute Cargo Clauses as above)

        a)       Breakage, scratching, chipping, denting or bruising.
        b)       Gradual deterioration, moths, vermin, rust, mildew, any process of cleaning or repair.
        c)       Mechanical, electrical or electronic derangement.
        d)       Consequential loss of any kind.
        e)       Depreciation resultant upon repairs claimed for under this insurance.
        f)       Detention from any cause or confiscation by Customs officials.
        g)       Foodstuffs, cash, banknotes, stamps, securities or documents of value.
        h)       Containers other than suitcases or trunks properly cased.

3.      DURATION OF COVER:

        Clauses 8.1 to 8.1.3 of the Institute Cargo Clauses (A) and Clauses 5.1 to 5.1.3 of the Institute Cargo
        Clauses (Air) are deemed to be deleted and replaced by the following:




        This insurance attaches from the time the goods leave the warehouse, place of storage or Insured's
        domicile at the place named herein for the commencement of the transit and continues whilst at
        packers premises
        during the ordinary course of packing and thereafter during the ordinary course of transit and
        terminates either:

        a)       On delivery to the Insured's domicile at the destination named herein.
        b)       On delivery to any warehouse or place of storage whether prior to or at the destination which
                 the Insured elects to use for storage other than in the ordinary course of transit
                 whichever shall first occur.

4.      If the property covered by this insurance shall at the time of any loss or damage be greater value than
        the sum insured hereby, the Insured shall only be entitled to receive hereunder such proportion of the
        said loss or damage as the sum insured by this policy bears to the total value of the said property.

5.      In the event of loss of and/or damage to any articles forming part of a pair or set, the Insurers' liability
        shall be limited to the value of such part or parts which may be lost or damaged, without reference to
        any special value which such articles shall have as part of such pair or set, nor shall it exceed the
        proportions part of the insured value of such pair or set.
6.       In the event of damage to any article or any part thereof in respect of which there is a valid claim, the
         Insurers shall have the option of paying for the amount of the damage or having the article repairs or
         replaced in a reasonably sufficient manner.

7.       If this policy cover the insured goods from the Insured's domicile, the risk commences from the time
the
         insured goods leave the Insured's residence at the place named in the policy for the commencement
of the
         transit and continues at packers' premises during the ordinary course of packing and thereafter during
the
         ordinary course of transit until delivery at the place of destination named in the policy.




     ( Please refer to quote re whether cover 1 , 2 or 3 to apply )
                                                       OR

              HOUSEHOLD GOODS AND PERSONAL EFFECTS CLAUSE – HGPE 3



1.       COVER 3

         This insurance is against perils as defined in terms of the Institute Cargo Clauses (B) with
         sub – clause 1.2.3 deleted

         This insurance includes the risks or War and Strikes in terms of the relative Institute
         Clauses.

         Extended to include theft following Fire Collision Overturning of conveying vehicle as well
         as hijacking cover.

				
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posted:6/3/2011
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