Client Product Insurance

    Client Product Insurance Form

    Company name: (required)

    Your Email: (required)

    Please confirm if you require your stock goods to be insured by us ?

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    Name: (required)

    Position: (required)

    Date: (required)

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    Account Reference No: (required)

    Short description of goods stored on Flostream Premises (required)

    Estimated quantities of goods stored on Flostream Premises (required)

    Maximum value (in numbers and words) of goods stored on Flostream Premises, for insurance purposes. (required)

    Stock Location 1

    Value of Stock (in numbers) stored in location 1, for insurance purposes. (required)

    Stock Location 2

    Value of Stock (in numbers) stored in location 2, for insurance purposes. (required)

    Please Note:

    1. You will be required to take out your own additional insurance cover for any stock above the value stated above.

    2. Insurance provided by Flostream will cover the cost price of the goods only and does not cover loss of business or profit or any other liabilities.

    3. Goods stored in breach of the agreement, including hazardous and prohibited goods will invalidate the Flostream insurance cover for your goods, including any goods stored which do not breach the agreement.

    I confirm that the total value of goods stored in any Flostream locations will not exceed the above stated amount and only the provable cost of the goods is covered. I will obtain my own insurance if extra cover is required.

    Signed By: (required)

    Date: (required)

    Print Name: (required)

    For and on behalf of [Company name] (required)

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