Construction of Harbours, Breakwaters, Quay Accommodations, Piers, Docks / Page 1 of 2
GENERAL INFORMATION:
- Name of Project:
- Site: river mouth coast river lagoon bay lake
PROJECTVALUES:
Item / Values
Site installations and temporary work / $
Workshops, stores, camps, etc. / $
Dredging / $
Excavation / $
Filling / $
Breakwaters / $
Quay Walls / $
Piers / $
Warehouses, silos, office buildings / $
Road and railway facilities / $
Supply lines (gas, water, electricity, telephone, etc.) / $
Technical installations (cranes, elevators, etc.) / $
Other work / $
TOTAL / $
PROJECT DETAILS:
- Type of project: commercial military sports other:
- Type of quay/pier: passenger traffic bulk material containers other:
- a) Breakwaters Type: rock fill concrete blocks/tetrapods caissons sheet piling other:
Dimensions: Length: m / ft / Top width: m / ft / Base width: m / ft
Maximum depth of water: m / ft / Other particulars:
b) Piers/quays: Number of piers/quays:
Top of piers above mean high-water mark: m / ft
i) sheet-piled / Sheet pile wall backfilled with: sand concrete other
ii) caisson / round, diameter square, length cast in situ cast in dock
Pulled into final position: by barge by winch
on piles made of: timber steel concrete
Capped by: in-situ concrete precast beams
iii) If other methods, please specify:
- Traffic links: rail road both
- Buildings/structures:
sheds warehouses terminals club houses railway station tank farms offices other
If other, please provide details:
- Natural Hazards: monsoon tropical storms (hurricane, typhoon, cyclone)
Maximum rainfall: / per month: m / per hour: m / Observation period: years
Maximum wind velocity: km/h / mph / Observation period: years
Main wind direction: / Has the area been subject to flood or tidal waves? YES NO
Height: m / ft / Observation period: years
Direction: / Frequency:
Protective measures:
- To what extent might the contract works be destroyed in one loss event?
SCHEDULE OF CONSTRUCTION:
Component / Anticipated Period Of Work (Months)
Site installations and temporary work
Dredging
Excavation
Filling
Breakwaters
Quay Walls
Piers
Warehouses, silos, office buildings
Road and railway facilities
Supply lines (gas, water, electricity, telephone, etc.)
Technical installations (cranes, elevators, etc.)
Other work
- What work will be done by subcontractors?
- Which contractors will work independently of the insured at the site and what work will be done by them?
- a) Where are the offices, stores, workshops, camps, etc. located? Please provide details.
Where are construction plant and equipment and construction materials stored? Please provide details.
b) To what extent will these facilities be protected against flood? Please provide details.
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Applicant’s Name: / Applicant’s Signature:
Brokerage: / Broker Signature:
Date: / Email:
Fax No: / Tel No:
Premier Canada Assurance Managers Ltd. is one of Canada’s largest Managing Underwriting Agents. The underwriting insurance carrier varies by line of business and region - please refer to specific quote for declaration of the underwriting insurance company(s).
** Email application and attachments to - **
Vancouver - T 604.669.5211 F 604.669.2667 / London - T 519.850.1610 F 519.850.1614
Rev. Oct 23, 2014