Solar Photovoltaic (P.V.) Insurance Questionnaire
Solar P.V. Insurance Questionnaire This Proposal form and all materials submitted shall be held in confidence. All questions must be fully answered and all requested information and/or required attachments submitted to enable a quotation or indication to be given. However, the completion and submission of this form does not bind the applicant or CNA Insurance Company Limited ( CNA ) to enter into any contract of insurance. If a question does not apply, please write N/A. If the answer is none, state none or 0. If more space is needed, please continue on a separate sheet of the applicant s letterhead and indicate the question number to which the information responds. This Proposal form and any separate continuation sheets must be completed, signed and dated by a principal of the applicant business. It is your duty to disclose to CNA all facts material to the proposed insurance. A material fact is one which is likely to influence CNA in the acceptance or assessment of this Proposal form and it is essential that you disclose them. If you are in doubt whether a fact is material, you should disclose it as failure to do so could prejudice your rights to recover in the event of a claim or allow CNA to void the policy. 1. General Information: Project name Project summary Principle named insured Insured address Postcode Contact name Contact phone number Additional insured Name Address Loss payee Postcode 2
2. Project Site Details: Actual project location Project site address Postcode Year built Natural perils exposure: earthquake, storm, flood or other? Please describe the exposure Solar park overview please provide a site plan to include the solar parks, sub station, access roads, transmission lines and any other details such as other solar parks which connect to the export sub station. Location of PV panels; example warehouse, farm storage area, solar park Are the PV panels fixed in position, single axis or double axis movement? If PV panels are located on roof of a building what is stowed beneath 3
Security is an insurance requirement please provide full details Examples include CCTV, fenced, guarded, the response time of security company For high risk areas from theft and new construction CNA would look for anti theft measures for the copper cable and panels 3. Insurance Coverage Required: Marine Transit Marine Delay in Start Up (DSU) Marine geographical scope, Limit any one transport, mode of transport Construction All Risks (CAR) Operational All Risks (OAR) Construction DSU Business Interruption (BI) Description of supplier and customer dependency Third Party Liability Number of employees Company turnover Description of occupancy, including any work performed at customers Surrounding property exposure Other Insurance covers required 4
Business interruption indemnity period in months Annual electricity production Effective policy date and period Deductibles requested 5,000 10,000 15,000 20,000 Other deductible value/period 3 days 5 days 7 days 10 days Is there a manufacturers warranty in force? Yes No Scope of cover? Warranty expiry date? 4. New Build Construction Details: Main contractor name Address Project start date and length of project Postcode Project plan attached Yes No 5. Statement of Values: Currency Description Green certificate for electricity Civil constructions Roads 5
Equipment Number of PV panels Manufacturer, model Value of PV panels Number of inverters Manufacturer, model Value of inverters Tracker units are they single or dual axial Number of motors connected with the tracking system Value of the tracker units In respect of the export transformer/transformers Please confirm the ownership Manufacturer and rated capacity Value of the transformer/transformers In respect of the transmission export lines Please confirm if they are buried or overhead Please confirm the ownership of the transmission line Length of transmission line/lines and value/values 6
6. Total Sums Insured: Total value machinery Total value construction all risks Total value delay in start up Total value operational all risks Total value business interruption 7. Site Exposures: Details of the fire detection and protection for (please include the fire water supply and distance to the nearest fire brigade) A, if the PV panels are roof mounted the building below, the details should also include the construction of the building B, the export transformer In respect of Vegetation for solar parks please confirm the service contract includes restricting vegetation growth 8. Maintenance Contracts: Please provide details of the solar installation/transformer service contracts Name of contractors Years of experience in servicing Emergency response capability 7
9. Major Spare parts on site and access to Critical Spares: Please provide details of any major spare parts held on site Examples: PV panels, inverters, electric motors for trackers, transformers In respect of the export Transformer please confirm the time to replace if the export transformer fails 10. Claims: Please document the last 5 years claims detailing the year of occurrence, claim event, monetary value of the property and business interruption 11. Any Other Information: Please detail any other information you think that would be useful in evaluating this plant including when you would like a quote to be completed 8
12. Questionnaire Completed By: Name Title Company Date 13. Declaration 1 I/We warrant to the best of my/our knowledge and belief that all the information contained in this Proposal form is true and includes all material facts; 2 I/We warrant that I/we have not misstated, omitted or suppressed any material facts; 3 I/We further warrant that if information supplied herein changes between the date of this Proposal form and inception date of this cover, I/We will immediately notify CNA of such change and accept that in such circumstances the quotation may be modified or withdrawn. 4 I/We agree that this Proposal form and declaration, and any information given separately, shall be the basis of the contract between CNA and myself/ourselves. 5 I/We agree to accept CNA s standard form of policy for this type of insurance. 6 I/We understand that CNA reserves the right to decline any proposal. Name Date 2 Minster Court Mincing Lane London EC3R 7BB United Kingdom Tel +44 (0)20 7743 6800 Fax +44 (0)20 7743 6801 www.cnaeurope.com CNA Insurance Company Limited Registered in England number 950 Registered Office: 2 Minster Court Mincing Lane London EC3R 7BB VAT registration number 667557779 A member of the Association of British Insurers A Member of the CNA Financial Group Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (number 202777) CNA Europe is a trade mark of CNA Financial Corporation CNA is a registered trade mark of the CNA Financial Corporation 21873/0414