General information

Questionnaire for Property Insurance

Fire & Allied Perils

Insured :-

Insured object:-

Activity:-

Location :-

1) Purpose of Inspection:-

· Risk inspection

· Drawing up Recommendations

· MPL/EML Estimate

· Visit to risk

· Other :-

2) Summary

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3) Risk Information :-

31 general

311 year of construction

312 work force

313 working hours

314 recent major changes

315 planned major changes

316 layout

317 neighborhood

318 special exposures(aircraft,

flood, storm, earthquake etc)

319 accessibility:

32 main activities

33 Buildings

Buildings no	Type	No. of Stores	Height (m)	Separations (fire walls)	Smoke & Heat Extraction	Remarks *

· P = Protected (nature of protection)

· UP= Unprotected

· OA= Open air plant

34 energy supply

341 electricity

342 Oil , coal , gas ,etc

343 steam

344 compressed air

345 process water

346 heating

347 air-conditioning

348 cooling

345 electrical installations

	Excellent	Good	satisfactory	unsatisfactory
Condition
maintenance

	Available	Not available
Lightning conductor
Grounding

Remarks:-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

36 materials and goods

Materials and Goods	Packing , storage (Quantities)

37 Process

Building / Plant Area	Processes	Special hazards

38 Maintenance

	excellent	good	satisfactory	unsatisfactory
General
Preventive
Building