Online Proposal Form Questions For SLA Scheme Your DetailsName of insured*Subsidiary companies to be covered by this insurance, if any*Do you have overseas entities?*YesNoDo you want to include them in this coverage?YesNoPlease specify entity namesPlease select the plan you wish to be insuredBronzeSilverGoldPlatinumGross Freight Receipts* for coming year(*Gross revenue including payments to agents and sub-contractors in respect of Insured Services but excluding customs duty, sales tax or similar fiscal charges paid on behalf of the Customer.)Freight information to be completed:Specific Freight against Turnover (Indicate Percentage)Containerized (dry)Please enter a value greater than or equal to 0.Containerized (temperature controlled goods)Please enter a value greater than or equal to 0.BreakbulkBulkHousehold goods and personal effectsDangerous goodsNumber of employeesDetails on transport servicesFreight forwarders (as agents using Principal’s bills)Number of yearsTurnover (Indicate Percentage) % NVOCC (as principal issuing own bills of lading)Number of yearsTurnover (Indicate Percentage) % Customs brokerNumber of yearsTurnover (Indicate Percentage) % Road transport operatorNumber of yearsTurnover (Indicate Percentage) % Warehouse operatorNumber of yearsTurnover (Indicate Percentage) % Marine insurance agentNumber of yearsTurnover (Indicate Percentage) % Voyage detailsAfricaAsia PacificEuropeMiddle EastNorth AmericaSouth AmericaWarehousing and storage cover required?YesNoNumber of warehouse locationsList down warehouse locationsAre your Standard Trading Conditions incorporated into all business transactions with your customers and sub-contractors?YesNoAre your Standard Trading Conditions incorporated into all business transactions with your customers and sub-contractors?YesNoDo you annually check your sub-contractors’ insurance policies?YesNoDo you have any non-standard contracts with your customers and/or principals? Note: If yes, Honan will contact client to ask for the more detailsYesNoAny B/L or AWB or consignment note for road transport under the followinga) FIATA or COMBICON bill of ladingYesNob) National Freight Forwarder Association bill of ladingYesNoc) Applicant’s house bill of lading/house AWBYesNod) Any other transportation conditionsYesNoPlease complete the following:Existing Year 2017GFRClaimClaim detailsPaidOutstanding SGDLast Year 2016GFRClaimClaim detailsPaidOutstanding SGDTwo years ago 2015GFRClaimClaim detailsPaidOutstanding SGDEmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.