IMPORTANT: For a correct valuation, it is indispensable that all the data of this questionnaire are answered. The marked fields with asterisk are obligatory.

TYPES OF INSURANCE
Decennial Damage Insurance

All Risk Construction Insurance
O.C.T.
Civil Responsibility for Const. Companies
Geotechnics
Premature Cuantities Insurance

COMPANY/CLIENT

Name(*):

Person of Contact(*):

Address:

City: C.P.:

Phone(*): Fax: NIF/CIF:

e-mail(*):

DATA OF THE PROMOTION

Address of the work

City County

Does it work of new plant? Does it reform?

Has the geotecnic study of the floor been carried out?

Multifamily building? Number of housing:

Unifamily isolated housing? Unifamily embedded housing?

Unifamily paired housing? Among dividing?

Nº plants low slope: square meters low slope:

Nº plants on slope: square meters on slope:

Lot surface(m2):

PRESUPPOSED AND TERMS OF EXECUTION

Presupposed (PEM):

It dates foreseen of beginning:

Duration: Does it already work initiate?

Executed works:

SPECIALS CONSTRUCTIVE CHARACTERISTICS
Thermoclay covering less than 29 cm? Celular concrete?

Wood?

Type of foundation: Tracks Steer Stone slab Shaft

Others

Type of Structure:  Metallic Concrete Mixed Wood

Others

Type of Cover: Plane passable Plana non passable Banked

Others

Type of Covering: Brick Panels Concrete Blocks Wall Curtain

Care/Honorarium/Technicians/OCT/Licenses/IVA...:

DATA FOR O.C.T.
Does hired OCT have?    Name company OCT: