{"id":2579,"title":"Deterioration of Stocks Insurance (Potatoes) PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/deterioration-of-stocks-insurance-potatoes/Deterioration-of-Stocks-pf.pdf","sha256":"5747eac349f94e8c46e8ed2bf0e92027c71e74ee78fcd0b73e0e1c46f4d01bb6","pages":8,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for insurance coverage against deterioration of potato stocks stored in cold storage. It is filled by the proposer who owns or leases the cold storage.","notes":["If space is insufficient for any answer, continue on a separate sheet and attach.","Attach specimen copies where requested.","The liability of the company does not commence until the proposal is accepted and premium paid.","Use the exact details as per records for all technical and insurance information."],"title":"Deterioration of Stocks Insurance (Potatoes) PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"I. Proposer Details","fields":[{"help":"","type":"text","label":"Proposer : (a) Name","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"In the cold storage owned by you or taken on lease?","options":["Owned","Taken on lease"],"required":null,"pdf_field":""},{"help":"Describe your contractual obligations","type":"text","label":"What are your contractual liabilities to your customer?","options":[],"required":null,"pdf_field":""},{"help":"Duration in years or months","type":"text","label":"How long have you been running the cold storage?","options":[],"required":null,"pdf_field":""},{"help":"If yes, specify cause and amount","type":"text","label":"Have you suffered any losses due to deterioration in the past? Give details of cause and amount.","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"II. Previous Insurance Details","fields":[{"help":"If yes, provide company name and insurance period","type":"text","label":"Was the plant insured for machinery breakdown and deterioration of stocks previously? If so, please give name of Insurance Company and period of Insurance.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If yes, provide company name and reason","type":"text","label":"Was the Insurance at any time declined by any Company? If so, by whom and for what reason.","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Constitution Details","fields":[{"help":"Select the constitution type and provide DARPAN details if applicable","type":"choice","label":"Constitution Details","options":["Partnership Firm","Limited Liability/Partnership Firm","NGO/NPO - Provide DARPAN Portal Registration, if applicable","Company","Trust","Society","Section 8 Company","Proprietorship Firm","Others (Please specify)"],"required":null,"pdf_field":""},{"help":"Provide DARPAN Portal Registration details if applicable","type":"text","label":"DARPAN DETAILS","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"III. Period of Insurance","fields":[{"help":"Specify the insurance period","type":"text","label":"Give the period of Insurance required by you.","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"IV. Stock and Insurance Details","fields":[{"help":"Maximum quantity of stock","type":"number","label":"What would be the maximum stock of goods stored by you at any time during the season?","options":[],"required":null,"pdf_field":""},{"help":"Price per quintal including storage charges","type":"amount","label":"State the price per quintal at which you wish to insure the stock (this price should include storage charges)","options":[],"required":null,"pdf_field":""},{"help":"Total sum insured in rupees","type":"amount","label":"Sum to be insured : Rs........","options":[],"required":null,"pdf_field":""},{"help":"Attach specimen copy if yes","type":"yes-no","label":"Do you maintain any stock register? If so, please attach a specimen copy with this form.","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"V. Cold Storage Details","fields":[{"help":"Provide number, size and capacity details","type":"text","label":"Give details of cold storage rooms number, size, designed storage capacity.","options":[],"required":null,"pdf_field":""},{"help":"Name of designer or firm","type":"text","label":"By whom the cold storage is designed? Give the name of the designer/firm engineer.","options":[],"required":null,"pdf_field":""},{"help":"Type of insulation","type":"text","label":"(a) Indicate the type of insulation used in the refrigeration chambers.","options":[],"required":null,"pdf_field":""},{"help":"Attach sketch of insulation","type":"attachment","label":"(b) Give cross-sectional sketch of insulation of all sides.","options":[],"required":null,"pdf_field":""},{"help":"Date and party who did insulation","type":"text","label":"(c) When was the present insulation done and by whom?","options":[],"required":null,"pdf_field":""},{"help":"Date of last replacement","type":"date","label":"(d) When was the present insulation last replaced?","options":[],"required":null,"pdf_field":""},{"help":"Details of racks design and constructors","type":"text","label":"Give the design and type of materials used for storage racks and the name of firm/engineers who designed, constructed them.","options":[],"required":null,"pdf_field":""},{"help":"Types of goods stored","type":"text","label":"(a) What goods do you store?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"(b) Do you accept stocks of high yielding variety?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"(c) Do you ascertain that the stocks offered for storage are free from disease?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify storage method","type":"text","label":"(d) How do you store the goods? In bags, containers or loose?","options":["Bags","Containers","Loose"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"(e) Do you sort out bad stocks before storage?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"(f) Do you check for spoilage of stored goods and arrange for their removal?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Time duration to remove stocks","type":"text","label":"(g) What time will be required to remove the stocks in case of breakdown.","options":[],"required":null,"pdf_field":""},{"help":"Alternate storage details if any","type":"text","label":"(h) In the event of loss, is there any possibility of storing the goods in your charge elsewhere? If so, give full name & address.","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"(i) Are you authorised to dispose off the goods stored to avoid or minimise losses due to deterioration etc.?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify temperature and humidity conditions","type":"text","label":"(a) What conditions of temperature (indicate in degree C or F) and relative humidity do you maintain in the cold storage for different goods stored.","options":[],"required":null,"pdf_field":""},{"help":"Describe air circulation and control methods","type":"text","label":"(b) How do you ensure proper circulation of cold air or proper conditions of temperature and humidity in the cold rooms?","options":[],"required":null,"pdf_field":""},{"help":"Explain loading control methods","type":"text","label":"(c) How do you ensure the proper loading of cold rooms within the designed capacity.","options":[],"required":null,"pdf_field":""},{"help":"Frequency of checks","type":"text","label":"(d) At what intervals are the temperature and humidity checked?","options":[],"required":null,"pdf_field":""},{"help":"If yes, specify control type","type":"text","label":"(e) Is the cold storage plant equipped with automatic control system? If so, what is the type of control?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"VI. Electric Supply Details","fields":[{"help":"","type":"choice","label":"What is your main source of electric supply? Your own generation or from public grid.","options":["Own generation","Public grid"],"required":null,"pdf_field":""},{"help":"Specify voltage","type":"text","label":"State input voltage if power is obtained from the Public grid.","options":[],"required":null,"pdf_field":""},{"help":"Specify location and ownership","type":"text","label":"If a transformer is required for the input voltage is it located in your premises and are you the owner?","options":[],"required":null,"pdf_field":""},{"help":"If yes, provide details","type":"text","label":"Has the power supply been interrupted at any time during the last three years? If so, state number and duration of interruptions.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If yes, describe standby arrangements","type":"text","label":"Do you have stand by arrangement in the event of failure of main source of electric supply? If so, give details.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify expected hours","type":"text","label":"After how many hours (24, 48, 72 or more) do you expect the stored goods to deteriorate due to a rise or fall in temperature in consequence of machinery breakdown and/or failure of power supply.","options":["24","48","72","More"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"VII. Machinery Details","fields":[{"help":"Provide names of firms or engineers","type":"text","label":"By whom the machinery has been : (a) manufactured? (b) supplied? (c) erected? (Give the name of firm/engineers)","options":[],"required":null,"pdf_field":""},{"help":"Details of compressors","type":"text","label":"Give details of : (a) Refrigerating compressors, number, make capacity in tons, bore, stroke, R.P.M.","options":[],"required":null,"pdf_field":""},{"help":"Specify type and details","type":"text","label":"(b) Are the compressors driven by electric motors or diesel engines? Give details of driving motor or diesel engine, i.e. H.P.","options":["Electric motors","Diesel engines"],"required":null,"pdf_field":""},{"help":"Provide serial and technical details","type":"text","label":"Serial Number, make, bore, stroke, R.P.M., type and voltage.","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are there several independent refrigerating systems and if so, is it possible to switch from one to another.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of condenser stands","type":"text","label":"Give the number and type of condensor stands.","options":[],"required":null,"pdf_field":""},{"help":"Name of refrigerant","type":"text","label":"State the refrigerant used.","options":[],"required":null,"pdf_field":""},{"help":"Pump and motor details","type":"text","label":"Give details of circulating water pumps: (a) Capacity in gallons per minute and head in ft/metre. (b) H.P., R.P.M., type and voltage of driving motors.","options":[],"required":null,"pdf_field":""},{"help":"Number of standby units for each equipment","type":"text","label":"Give the number of stand by spare units: (a) Compressors under loading conditions (b) Compressors under normal conditions. (c) Circulating water pumping sets. (d) Electric motors for diffusers. (e) Any other equipment.","options":[],"required":null,"pdf_field":""},{"help":"Details of spare parts stock","type":"text","label":"Do you keep a stock of replacement spare parts for :(Give details) (a) Compressors. (b) Driving motors. (c) Engines. (d) Pumps etc.","options":[],"required":null,"pdf_field":""},{"help":"Inspection and servicing details","type":"text","label":"(a) Is the plant inspected and serviced regularly by a recognised firm of cold storage specialists or by refrigeration plant engineer and if so, at what intervals?","options":[],"required":null,"pdf_field":""},{"help":"Supervisor details","type":"text","label":"(b) Is the plant under supervision of a qualified and experienced refrigeration engineer/mechanic. Give name, qualifications, experience of the engineer, mechanic-in-charge.","options":[],"required":null,"pdf_field":""},{"help":"Attach specimen copy if yes","type":"yes-no","label":"(c) Do you maintain a log book for the maintenance of plant and the conditions of temperature and humidity in the cold rooms? If so, give a specimen copy of the same.","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"VIII. Insurance Commencement Date","fields":[{"help":"Specify start date of insurance","type":"date","label":"State the date when the Insurance is to commence. Date..... Month.... Year...","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signature","fields":[{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Signature of proposer","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Politically Exposed Persons (PEP) Declaration and Consent","fields":[{"help":"PEP means politically exposed persons as defined","type":"yes-no","label":"Are you or any of the proposal applicants a PEP* or a close relative of PEP*? If yes, please share the details","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Consent for KYC verification","type":"yes-no","label":"I/we hereby give my/our consent to the Company to verify and obtain my/our identity/address proof through CERSAI records or National Securities Depository Limited Portal for the purpose of undertaking KYC verification.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Declaration of legal source of premium","type":"yes-no","label":"I/we hereby declare and confirm that the premium has been paid out of legally acquired sources of income and the subsequent premiums if any, will continue to be paid out of legally declared and assessed source of income.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Consent for sharing personal information","type":"yes-no","label":"I/We hereby give voluntary consent to Bajaj General/Company to share my/our personal information and data provided in this proposal form with its group companies or any other person in connection with the Insurance Policy or otherwise, including for providing products and services of group companies that may be of interest to me/us, to be used in accordance with their respective privacy policies and subject to appropriate measures being in place to safeguard my/our personal information","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Deterioration of Stocks Insurance (Potatoes)","attachments":["Specimen copy of stock register (if maintained)","Cross-sectional sketch of insulation of all sides","Specimen copy of log book for maintenance of plant and conditions of temperature and humidity (if maintained)"],"declarations":["The proposer declares that all statements are true and complete and form the basis of the contract.","If any untrue statement is contained, the contract shall be null and void.","The proposer undertakes to exercise reasonable precautions for machinery safety.","The proposer agrees to accept the policy subject to terms, conditions, and exceptions prescribed or endorsed.","No person shall offer or accept rebates on commission or premium except as allowed by insurer's published prospectus or tables.","Non-compliance with rebate provisions is punishable with fine up to ten lakh rupees."],"dropped_labels":2},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"email","value":"careforyou@bajajgeneral.com","label":"Customer Service Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"in a new tab\nBajaj General Insurance Limited\nTollfree: For sales :\n1800-209-0144\nFor service :\n1800-209-5858\nEmail id:\ncareforyou@bajajgeneral.com\nFor senior citizens:\nseniorcitizen@bajajgeneral.com\nFor senior citizens:\n1800-209-5858\nFax no:\n020-30512246\nRegistered","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-209-5858","label":"Service Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"Careers\nBecome\n                                An Agent\nAwards\nUpdate KYC\nMY ABHA\nBuy Policy:\n1800-209-0144\n| Service:\n1800-209-5858\nService Chat:\n+91 75074 25858\nInsure\nHealth Insurance\nIndividual Health Insurance\nFamily Health Insurance\nInternational","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-209-0144","label":"Sales Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"nsurance\nSupport\nAbout Us\nCareers\nBecome\n                                An Agent\nAwards\nUpdate KYC\nMY ABHA\nBuy Policy:\n1800-209-0144\n| Service:\n1800-209-5858\nService Chat:\n+91 75074 25858\nInsure\nHealth Insurance\nIndividual Health Insurance\nFamily Healt","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-209-5858","label":"Customer Service Toll Free Number","level":1,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"ted servicing team to help you meet your service needs.\nCustomer Service - We're Here to Help\nDial our Toll Free Number\n1800-209-5858\nEmail us on\ncareforyou@bajajgeneral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Cha","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"ggro@bajajgeneral.com","label":"Grievance Redressal Officer Email Mr. Jerome Vincent","level":2,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"fied with the response given to you by our team, you may write to our Grievance Redressal Officer Mr. Jerome Vincent at\nggro@bajajgeneral.com\nLevel 3\nHead Customer Service\nif you are still not satisfied with the solutions provided, or have some feedback for us,","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-209-7073","label":"Toll free No. Intermediary","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"Here to Help\nDial our Toll Free Number\n1800-209-5858\nEmail us on\ncareforyou@bajajgeneral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Chatbot\nConnect with us on WhatsApp +91 7507425858\nFor Support\nBajaj General App\nPle","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"whatsapp","value":"+91 7507425858","label":"BOING WhatsApp Chatbot","level":null,"hours":"24x7","applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"ral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Chatbot\nConnect with us on WhatsApp +91 7507425858\nFor Support\nBajaj General App\nPlease scan and download\nMissed Call Facility\nMissed Call - 80809 45060 Short code - SMS","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/bajaj-general-insurance/2579-deterioration-of-stocks-insurance-potatoes-proposal-form"}