机器损坏险投保单 

　　machinery breakdown insurance application 

　　保单号：___________________

　　policy no. ________________

　　本投保单由投保人尽可能如实地、详细地填写并签章后作为向本公司投保机器损坏险的依据。本投保单为该机器损坏险保险单的组成部分。 

　　the applicant is required to fill in the following items with utmost faith and as detailed as pos-sible. and affix signature to this application, which shall be the basis of application to the company for machinery breakdown insurance and constitute an integral part of the machinery breakdown in-surance policy. 

　　1.被保险人名称和地址name and address of the insured:

　　2.营业性质nature of business:

　　3.被保