机器风险调查问卷

机器风险调查问卷

 

1．企业名称及地址/ Name and Address of Applicant：

                                                                                                                

3．被保险机器地址/ Location of insured machinery：

                                                                                                                        

6．工厂附近是否有火车站、机场?/ Is there a railway station/airport in the vicinity of the factory?      □是/ Yes  □否/ No

                                                                                                                   

7．最近三年是否受到过损坏?/ Whether a breakdown sustained in the past three years?               □是/ Yes  □否/ No

如是，请列出机器名称、损坏时间、原因和金额/If so, please state name of the machine

sustaining breakdown, time, cause and amount of the loss：

                                                                                                               

8．损失后是否完全修复?/ Has the machine-sustaining breakdown been completely repaired?           

□是/ Yes  □否/ No

                                                                                                               

9．是否经过试车验收并取得合格证?/ Whether the acceptance test has been past and the certificate of quality has been obtained?  □是/ Yes  □否/ No

                                                                                                             

10．是否有制造厂商，安装者的责任保险期?/ Is there maintenance period given by the manufacture and the erector? □是/ Yes  □否/ No 如是，请列出期限：/If so, please state the maintenance period：

                                                                                                              

11．进口的技术合同是否有明细单价?/Whether the unit prices have been specified on the technical and purchase contracts of imported machinery? □是/ Yes  □否/ No

                                                                                                            

12．外文使用说明书及技术资料是否已全部译成中文?/Have operation instructions and technical materials been translated into Chinese? □是/ Yes  □否/ No

                                                                                                              

13．各种使用说明书是否已组织管理、技术及操作人员学习培训?/Have administrative, technical and operating staffs been organized to study the operation instructions? □是/ Yes  □否/ No

                                                                                                                

14．设备的管理、使用、维护和保养工作制度是否符合有关当局或主管部及制造厂家的要求?/Do the regulations for management, use, maintenance and overhaul of machinery comply with the requirements of relevent           authority or institution and the manufacturer? □是/ Yes  □否/ No  

                                                                                                            

15．是否有严格的管理、监督制度以保证各种操作规范的实施?/Are there strict regulations for management and supervision to guarantee the implementation of all kind of operation instruction? □是/ Yes  □否/ No 

                                                                                                            

16．机器设备的供电电压是否稳定?/Whether the voltage of the electricity supply to the machinery is steady?

□是/ Yes  □否/ No

                                                                                                                

17．是否配备了稳定电压的装置?/Whether any device for voltage control is installed?   □是/ Yes  □否/ No

                                                                                                                   

18．机器所在的厂房是否符合当局规定的建筑质量标准和安全使用要求?/Whether the factory building where machinery is placed complies with construction quality standard issued by the relevant authority and the requirement for safe use? □是/ Yes  □否/ No

                                                                                                              

19．机器周围的生产活动是否属于企业的正常经营?/Whether the production activities around machinery are parts of the normal production? □是/ Yes  □否/ No 

                                                                                                                

20．机器附近是否有建筑工程或安装工程?/Whether construction or erection works are in the vicinity of machinery?              □是/ Yes  □否/ No如有，请说明：/If so, please give description：

                                                                                                              

21．是否投保锅炉?/Whether boiler(s) is/are coved?                  □是/ Yes  □否/ No 

如是，请回答下列情况/If so, please answer the following questions：

（1）                      是否持有当局或有关部门签发的使用合格证?/Whether qualification certificates for use issued by the relevent authority or institutions is holded?              □是/ Yes  □否/ No 

（2）                      操作人员是否持有当局或主管部门签发的上岗合格证?/Whether qualification certificate for works issued by the relevent authority or institutions are holded by the operators?      □是/ Yes  □否/ No

（3）                      是否能够全部使用符合标准水质的水?/Whether the water up to the quality standard is used in the whole production process? □是/ Yes  □否/ No

（4）                      水源供应是否有充足的保障?/Whether water supply is sufficient?         □是/ Yes  □否/ No

（5） 锅炉房与最近的建筑物或财产的距离?Distance from the boiler house to the                          nearest construction(property) ?                            米/Meters

 

（6） 使用何种燃料?/ What kind use of fuel is used     □煤/ coal  □油/ oil  □电/ electricity  □其他/ other

（7） 锅炉使用性质/ Nature of use of boiler：         □生产用/ For production use  □生活用/ For daily use

（8） 是否进行过改造?/ Whether innovation has been made?                     □是/ Yes  □否/ No

（9） 最近两年内是否受到过损坏?/ Whether a breakdown sustained in the past two years?           

□是/ Yes  □否/ No

（10）最近一次正常维修保养距今有多长时间?/ How long does it last from the latest norma？