保险合同：货物运输保险单

保险合：货物运输保险单
　　处列货物拟处投保国货物运输保险：
　　编号：___
　　
　　|保险                                                                                                  |
　　||
　　|    标记发票号码    |    保险货物名称    |件    数|    提单通知单号次    |    保  险  金  额      |
　　||||||
　　|                      |                    |        |                        |                        |
　　|                      |                    |        |                        |                        |
　　|                      |                    |        |                        |                        |
　　|||
　　|运  输  工  具|                  |    约                  启                  |赔款偿|                |
　　|              |                  |          年    月    日                    |      |                |
　　|(转载工具)|                  |                      运                  |付点|                |
　　||||
　　|              |                  |  转载  |                                                            |
　　|运  输  路  线|            |  点  |                                                            |
　　||
　　|保险：基险    附加险      基险费率    ‰    附加险费率    ‰                                    |
　　|  |
　　|                                                                    |  投保单位签章                      |
　　|                                                                    |                                    |
　　|                                                                    |      年    月    日                |
　　
　　颁布 单 位 国家工商理局济合司
　　颁布 日 期
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