Insurance Policy and Certificate
To protect the interests of both customers and ourselves, it is imperative that all shipments made from us must be insured. Please choose one of the following insurance options, sign at the bottom and return this form (along with any additional information necessary) to us as soon as possible.
____ A. If you do not have your own insurance policy to cover inbound shipments, all orders will be automatically have an insurance charge added to the total. United Technology will take full responsibility/liability for any such shipment. Insurance will be added to your invoice, according to the following formula. Example: When ship by Federal Express, or any other common carriers agreed by United Technology, the insurance will be charged $0.50 per $100.00 value. If your order amount plus freight is $3,500.00, the insurance charge will be: $3,500.00 x 0.5/100 = $17.50.
____ B. If you have your own carrier insurance, please have your insurance company mail/fax us a copy of your Insurance Certificate (not your policy). The document must be showing insurance coverage for inbound shipments on common carriers and include with the following information: 1. Insurance company's name, address and telephone/fax numbers. 2. Policyholder's information (your company information must appear on the document). 3. Effective period of the policy and policy number. 4. Amount covered by the insurance and your deductible. Note: Choose this option if you would like to use your own insurance policy, IN CASE OF LOSS OR DAMAGE REPORTED BY United Technology or the shipping company, YOU ARE RESPONSIBLE FOR THE FULL PAYMENT OF INVOICES IMMEDIATELY. United Technology is not responsible for the shipments, which are not insured because of failure to notify us of changes of your insurance status. By choosing this option and signing this document, you agree that: a. Your insurance will be used in case of loss and, b. You will be held fully responsible/liable for any loss of shipment.
Company Name:_____________________________________________________________
Authorized Officer Name (Print):________________________ Title:___________________
Authorized Signature:_________________________________ Date:___________________
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