Policy No. 保單號碼： Name Of Insured 投保人名稱： Contact Person 聯絡人： Contact No. 聯絡電話： E-mail Address 電郵地址：
Effective Date 生效日期 : CHANGES (Please select and state the details) 更改 (請選擇項目) : Name of Insured 受保人(a) Principal 主要受保人 (b) Management Company 管理公司 CHANGES (Please select and state the details) 更改 (請選擇項目) : Period of Insurance 保險期 (a) Policy starting date 起保日期 (b) Apply extending cover period to (may cause additional charges) 申請延長保障期至 (或需要附加費用) CHANGES (Please select and state the details) 更改 (請選擇項目) : Contract SumContract Sum1 CHANGES (Please select and state the details) 更改 (請選擇項目) : Scope of works/ Contract Details 工程性質/ 合約內容Please upload new scope of work/ contract details 請上傳新工程性質/ 合約內容 Choose File 請選擇檔案 Checkbox Field1 I/We request that the policy be changed according to the above details. I understand and agree that this request will form part of the policy. I understand that this request is NOT valid until it is finally confirmed and accepted by Insurer(s) by way of Endorsement or letter/email. 本人在此要求保單按以上資料更改。本人明白及同意本申請將會構成保單契約之一部分。本人明白此申請需最終經保險公司批註或信 件/電郵確認方為有效。Checkbox Field2 I/We have read and understood the Personal Information Collection Statement and agree to be bound by the same. 本人已閱讀及明白個人資料收集聲明，並同意接受其約束。Checkbox Field3 I/We hereby confirm to agree the privacy policy and terms and condition of this website. 本人確認已閱讀及同意本網頁之使用條款及私隱條例。
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