{"id":2580,"title":"CONTRACTORS' PLANT & MACHINERY INSURANCE PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/contractors-plant-machinery-insurance/Contractor-Plant-Machinery-pf2.pdf","sha256":"77efcda97ec0d490026a276c5692ca5a5db0c93b2512be7b7037eb639ead0e9a","pages":7,"collected":"2026-10-17","instructions":{"about":"This form is used by individuals or businesses (proposers) to apply for Contractors' Plant and Machinery Insurance coverage by providing details about themselves, their machinery, and related information.","notes":["All questions must be answered completely; use annexure if space is insufficient.","It is mandatory to keep policy updated with contact and bank details for faster service.","Use original documents for claims processing; additional documents may be requested by the company.","Signature of proposer and witness required; authorized representative may sign if proposer is disabled.","Agent/intermediary must sign and provide license number.","The form includes a prohibition of rebates as per Section 41 of the Insurance Act 1938."],"title":"CONTRACTORS' PLANT & MACHINERY INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details","fields":[{"help":"Enter your full name as per Aadhaar Card","type":"text","label":"Proposer’s Name","options":[],"required":true,"pdf_field":""},{"help":"Select YES if name matches Aadhaar, else provide correct name","type":"choice","label":"Is your name mentioned above as per your Aadhaar Card? : YES No If No, Please mention the Name as per Aadhaar Card","options":["YES","No"],"required":true,"pdf_field":""},{"help":"Enter your Aadhaar Card number","type":"text","label":"Aadhar Card No.","options":[],"required":true,"pdf_field":""},{"help":"Enter your PAN number","type":"text","label":"PAN Number","options":[],"required":true,"pdf_field":""},{"help":"Enter your date of birth","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Select your gender","type":"choice","label":"Gender :  Male Female Other","options":["Male","Female","Other"],"required":true,"pdf_field":""},{"help":"Describe your trade or business","type":"text","label":"Proposer’s trade of business","options":[],"required":true,"pdf_field":""},{"help":"Enter your postal address","type":"text","label":"Proposer’s postal address","options":[],"required":true,"pdf_field":""},{"help":"Enter your telephone number","type":"phone","label":"Tel. No. :","options":[],"required":false,"pdf_field":""},{"help":"Enter your email address","type":"email","label":"E-mail :","options":[],"required":false,"pdf_field":""},{"help":"Provide the site location of the property to be insured","type":"text","label":"Location of operation (site of property to be insured)","options":[],"required":true,"pdf_field":""},{"help":"Mention nearest railway station and distance from site","type":"text","label":"Nearest railway station and distance","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Machinery and Insurance Details","fields":[{"help":"Answer if the listed machinery is all you use at the location","type":"yes-no","label":"Do the items listed represent the entire machinery used by you at the above location ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate if you currently have insurance","type":"yes-no","label":"Are you at present insured ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Name the insurer if currently insured","type":"text","label":"If so, with whom ?","options":[],"required":false,"pdf_field":""},{"help":"Indicate if machinery has defects or damage","type":"yes-no","label":"Are you aware of any defects/damage existing in the machinery ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details of defects or damage","type":"text","label":"If so, give details thereof","options":[],"required":false,"pdf_field":""},{"help":"Answer if other equipment is used on site","type":"yes-no","label":"Do you own or use any equipment other than that described above working on the same site ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Answer ownership and hiring out status","type":"choice","label":"Are you the owner of the propose equipment ? If yes, will you be hiring out ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate security of premises","type":"yes-no","label":"Are the premises where the equipment operates well guarded ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Describe site conditions","type":"text","label":"What is the site condition where the equipment will be utilised ?","options":[],"required":true,"pdf_field":""},{"help":"Indicate if equipment will operate on reclaimed or soft ground","type":"yes-no","label":"Are the equipments likely to operate on reclaimed or soft ground ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate risk of toppling and provide details if yes","type":"yes-no","label":"Are ground conditions such that equipment are exposed to the risk of toppling over ? If so, give details?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate susceptibility to natural calamities and precautions","type":"yes-no","label":"Is the site susceptible to flood, sea damage, storm, cyclone or other natural calamities? If so, give details and safety precautions taken.","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Answer if other contractors' equipment will operate on site","type":"yes-no","label":"Will equipment belonging to other contractors operate on the same site ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate availability of trained operators and statutory rules","type":"yes-no","label":"Do you have trained and qualified operators? Are there any statutory rules governing the appointment?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"List equipment requiring statutory inspection and certification","type":"text","label":"Which of the equipments are required to be inspected and certified for operation by statutory rules?","options":[],"required":false,"pdf_field":""},{"help":"Indicate if machinery was damaged in last 3 years","type":"yes-no","label":"Has your machinery sustained any damage from breakdown or other cause during last 3 years?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details of damages and repair costs","type":"text","label":"If so, give details of damage/s and repairing cost","options":[],"required":false,"pdf_field":""},{"help":"Indicate if periodic inspections are done","type":"yes-no","label":"Are regular periodical inspections of the machinery carried out ?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details of who inspects and inspection frequency","type":"text","label":"If so, by whom and at what intervals ?","options":[],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover express freight and related costs","type":"yes-no","label":"On payment of additional premium do you wish to cover : Express freight (excluding air freight), overtime and holiday rates of wages","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover air freight","type":"yes-no","label":"On payment of additional premium do you wish to cover : Air Freight","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover owner's surrounding property","type":"yes-no","label":"On payment of additional premium do you wish to cover : Owner’s surrounding property","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide indemnity limits if coverage selected","type":"amount","label":"If yes, provide limits of indemnity Rs.","options":[],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover clearance and removal of debris","type":"yes-no","label":"Clearance & removal of debris","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover additional custom duty","type":"yes-no","label":"Additional custom duty","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if you want to cover escalation","type":"yes-no","label":"Escalation","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide limit for third party liability per accident","type":"amount","label":"Third Party Liability : (i) For any one accident","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Schedule of Machinery to be Insured","fields":[{"help":"List each machine with all details in the table","type":"table","label":"SCHEDULE OF MACHINERY TO BE INSURED: Sr. No., Quantity, Description Type, Model, Capacity of Machine/ Serial No. HP / KVA Volts, AMPS, RPM, Maker’s Name and Country of Origin, Year of Make, Sum Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration and Signature","fields":[{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Sign or provide thumb impression","type":"signature","label":"Insured Farmer Signature / Thumb Impression","options":[],"required":true,"pdf_field":""},{"help":"Select mode of payment and specify if other","type":"choice","label":"Mode of Payment : Cheque - Given by : Cheque DD Cash Other","options":["Cheque","DD","Cash","Other"],"required":true,"pdf_field":""},{"help":"Declare if you or relatives are Politically Exposed Persons","type":"choice","label":"Declaration - Physical Proposal Form: Are you or any of the proposal applicants a PEP or a close relative of PEP? Yes/ No","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Declare any physical disability","type":"choice","label":"Disability Declaration: Any Physical deformity or handicap Yes No","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide disability details and certificate info","type":"text","label":"If Yes. Please provide details","options":[],"required":false,"pdf_field":""},{"help":"Sign the proposal form","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""},{"help":"Provide witness name","type":"text","label":"Name of Witness","options":[],"required":true,"pdf_field":""},{"help":"Witness signature","type":"signature","label":"Signature of Witness","options":[],"required":true,"pdf_field":""},{"help":"Signature of authorized representative","type":"signature","label":"Signature of Authorised representative","options":[],"required":false,"pdf_field":""},{"help":"Agent or intermediary signature","type":"signature","label":"Signature of Agent","options":[],"required":true,"pdf_field":""},{"help":"Place of agent signature","type":"text","label":"Place (Agent)","options":[],"required":true,"pdf_field":""},{"help":"Name of agent or intermediary","type":"text","label":"Agent/IMD Name","options":[],"required":true,"pdf_field":""},{"help":"Agent or intermediary code","type":"text","label":"Agent/IMD Code","options":[],"required":true,"pdf_field":""},{"help":"Name of sales person or point of sale","type":"text","label":"SP / BQP / DP / PoS Name","options":[],"required":false,"pdf_field":""},{"help":"Code of sales person or point of sale","type":"text","label":"SP / BQP / DP / PoS CoR No.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer and agent"}],"deadlines":[],"applies_to":"Contractors' Plant and Machinery Insurance policies","attachments":["Information annexure if space is insufficient","Disability Certificate issued by the Medical Board appointed by the Government for certifying Disability"],"declarations":["The liability of the Company does not commence until this proposal has been accepted and premium paid.","No person shall offer or accept rebates on premiums except as allowed by the insurer's published prospectus.","Non-disclosure or untrue statements may lead to policy being void and forfeiture of premiums.","Consent is given to verify identity/address through official registries for KYC purposes.","Premiums are declared to be paid from legally acquired sources.","Consent is given to share personal information with group companies for insurance and related services.","The proposer confirms understanding of the form's content and particulars.","Agent/intermediary confirms explanation of the form contents to the proposer in vernacular language if required."],"dropped_labels":18},"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/2580-contractors-plant-and-machinery-insurance-proposal-form"}