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Inland Carriers' Legal Liability Quotation
Personal Details
Proposer Type
Individual
Corporate
Government
Public Organisations
Associations
NGO
Staff
Proposer First Name
Proposer Middle Name
Proposer Last Name
Mobile No.
Email Address
Which Berhan Insurance S.C. branch do you want to be served from?
Select
ADM-ADAMA BRANCH
ARK-ARAT KILLO BRANCH
ARM-ARBA MINCH BRANCH
AYT-AYAT BRANCH
BDR-BAHIR DAR BRANCH
BEK-BEKLOBET BRANCH
BGR-BISRATE GEBRIEL BRANCH
BOL-BOLE BRANCH
DSS-DESSIE BRANCH
GOF-GOFA BRANCH
HAY-HAYAHULET BRANCH
HOF-HEAD OFFICE
HSN-HOSAENA BRANCH
HWS-HAWASSA BRANCH
JIM-JIMMA BRANCH
JKR-JACKROS BRANCH
KAZ-KAZANCHIS BRANCH
KER-KERA BRANCH
LBU-LEBU BRANCH
LID-LIDETA BRANCH
MAN-MAIN BRANCH
MEG-MEGENAGNA BRANCH
MER-MERKATO BRANCH
MKL-MEKELLE BRANCH
OLP-OLYMPIA BRANCH
PZZ-PIAZZA BRANCH
RAS-RAS BRANCH
SAR-SARIS BRANCH
SHE-SHERA TERA BRANCH
SHM-SHASHEMENE BRANCH
THM-TEKLE HAIMANOT BRANCH
WSD-WOLAITA SODO BRANCH
Risk Details
Insurance Start Date
Insurance End Date
Do you have any existing Carrier's Liability Policies in Berhan Insurance S.C.?
How many Vehicles do you have?
Please select method to add items
Please Select
UPLOAD FROM EXCEL
ADD MANUALLY
Last Row of Excel
Download Template
Excel
* Allowed file formats (xlsx)
Vehicle Details
1
Remove
Goods Types
Select
Dry Cargo
Fuel Cargo
Others
Goods Description
Owner Name
Plate No.
Chassis No
Carry Capacity
Number of Trips
Quantity Type
Unit Price Per Liter
Single Loss Liability
Est. Annual Liability
Security Details
Tracking Devices
Radio Communication
Any Other Devices
Overloading Devices
Engine Immobilizers
Any Other Devices
Type of Vehicle
Name of Beneficiary
Name of the party that care/ manage the carrier(s)
Indicate whether the Vehicles are ?
Select
Owned
Hired
Owned And Hired
Is Trailer Available?
Plate No. (Trailer)
Chassis No (Trailer)
Carry Capacity (Trailer)
Single Loss Liability (Trailer)
Est. Annual Liability (Trailer)
Total Single Loss Liability (Truck+Trailer)
Total Est. Annual Liability (Truck+Trailer)
Additional Benefits
Crane Cost
(Free Limit upto
30000
)
Loading & Unloading Expense
(Free Limit upto
0
)
Guarding & Protection Expense
(Free Limit upto
0
)
Transportation Cost
(Free Limit upto
0
)
Bagging & Packaging Cost
(Free Limit upto
0
)
Demmurage Cost Per Container
(Free Limit upto
0
)
Fire
Theft
BSG
Fragile Goods
Territorial Extension
Djibouti
Eritrea
Sudan
Kenya
Somalia
South Sudan
Other East African Countries
Other Vehicle Details
Is your liability to owners of goods determined by any conditions of carriage letter written or verbal?
Do you have a contract to carry under your conditions of carriage?
please attach a copy of Contract Document
Remove
Details of the nature of goods & the Container:
What is your area of Operations (Geographical area covered)?
Do you distribute goods to shops and/or street premises?
What security precautions do you take during loading and unloading?
Submit
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