ETHANOL PLANTS
CONSTRUCTION RISKS APPLICATION
NAME OF INSURED:
1.Insured’s Name:
2.Mailing Address:
3.Type of Ownership: IndividualPartnership Corporation Joint VentureOther
4.Are Lenders interests to be included in the policy ?
Details:
DETAILS OF MAJOR CONTRACTOR(S) / INSURED:
5.Name Of Employer / Principal:
6.On what basis will Contract be let, I.E. EPC (engineering, procurement & construction), Turnkey Contractor, Packaged Bids etc.:
7.Details of proposed Contractor(s) and/or Engineering providers and their direct experience with projects of this type and size:
8.Details of any builders risk claims during past 3 years of Contractor and/or Project Construction manager:
DETAILS OF PROJECT:
9.Location:
a)Address:
b)Basic site details, e.g greenfield, existing facility etc.:
c)Any surrounding exposures, such as Flood:
d)Any Natural Catastrophe exposure e.g. known Earthquake area:
Please attach summary of Geotech report.
10.Construction ofEquipment and Plant
a)Construction Materials:
b)Method of Construction:
c)Details of any renovation work of existing facilities:
d)Details of operating experience for manufacturers of key equipment and list of similar projects they’ve been involved in:
e)Lead times for key equipment:
f)Details of utility supplies and equipment:
g)Details of any major civil work required:
11.Site Layout
a)Arrangement of the equipment / plant:
b)Separation between process units / product streams:
Please attach diagram / site plan of plant, equipment, units and other structures, including breakdown of values, distances between each, and phase completion dates (if applicable).
c)Details / location of any on and off site laydown / storage areas:
12.Fire Protections and Security
a)Details of temporary and permanent fire protection facilities:
b)Confirmation of fire protection standard applied (e.g. NFPA, FM, LPC etc)
c)Details of dust suppression / explosion prevention systems:
d)Details and availability of trained fire fighting resources:
13.Quality Assurance
Please provide details of quality assurance / quality control plans:
14.Health, Safety and Security
a)Please provide details of health, safety and security programs:
b)And control of lifting operations:
15.Project Duration
a)Anticipated duration of project including duration of testing and commissioning phases:
b)Key / guaranteed operation / performance dates:
16.Project Costs
a)Breakdown of Replacement Cost Value / Project Costs:
b)Cost indications for major components e.g. complete mill, distillation column, process tanks etc.:
17.Delay in Start Up (if coverage desired)
a)Details of raw material supply arrangements:
b)Details of product sales agreements:
c)Details of any process bottlenecks, e.g. single corn crushing mill, single electricity supply line etc.:
d)To what extent does the project period / program have a “float”
(i.e. surplus buffer time allowance for completion)
DETAILS OF INSURANCE COVERAGE REQUIRED:
18.Sum(s) Insured
a)Hard Costs (Replacement Cost of Plant, Equipment, Materials, Labor etc)
USD
b)Soft Costs (Finance Costs, marketing expenses, legal and accounting expenses etc)
USD
c)Delay in Start Up USD
19.Deductible(s)
Construction Physical Damage Deductible - USD
Option - USD
Delay in Start Up – Excess of ………….…Days
20.Is Flood coverage desired, if so advise details of exposure:-
a)Distance from nearest body of water:
b)Height above body of water:
d)Is it in a Fed Flood Zone? If so which Zone?
21.Is Earthquake coverage desired ?
APPLICANTS SIGNATURE:……….………………………..DATE:…………………..