STANDARD LIABILITY PROTECTION
VALUATION FORM FOR OWNER PACKED EFFECTS
CUSTOMER DETAILS
Receiver Name
Name (as shown on your passport)
Destination address
Destination Phone
Country,City
Post / Zip Code
Waybill/Tracking No.
PROTECTION TYPE
3.5% Total Loss Insurance
5% All Risks Insurance
Please declare the quantity of items and values alongside each category indicated. Value declared should represent full destination replacement value,which can be considerably higher
than at origin. If the property is undervalued you will only be entitled to recover the proportion of the loss that the value bears to the total value of the property.
Please refer to www.dragonsea.co.uk for details and terms and conditions.
Please indicate below the breakdown of the total value declared. Individual items or sets over £250 value must be declared.
CATEGORIES
Value £
CATEGORIES
Clothing
£
Sport/Camping Equipment
£
Footwear
£
Golf Club/Tennis Racquet
£
Bag & Accessories
£
Surboards / Skies / Snowboards
£
Television/Stereo System
£
Bedding / Linen / Towels / Blankets
£
Game Console/Mobile
£
Tools / Workshop Equipments
£
Computer Desktop/Laptop
£
KItchen Utensils / Appliances
£
CDs / DVDs / Vinyl Records / Tapes
£
Books/Tops
£
Cameras / Photographic Equipment
£
Guitar-Electric/Piano-Electric
£
Musical Instruments
£
£
Works of Arts / Pictures / Souvenirs
£
£
BIcycles / Bicycle Equipments
£
£
Funiture
£
£
Carpets / Rugs
£
£
Quantity
TOTAL LIABILITIES VALUE PROTECTED
Quantity
Value £
£
I confirm that the statement and particulars given above are, to the best of my knowledge and belief, true and complete. I confirm that this Valuation Form shall form the basis the Mover
accepting Standard Liability in accordance with their Terms and Conditions on www.dragonsea.co.uk, which I have read. I understood that any item not declared on this form will be
excluded from Standard Liability. I understand that in the event of a claim, the mover reserves the right to deduct a £50.00 claim-handling administration fee.
(customer’s signature)
www.dragonsea.co.uk
tel: 0845 82 88888
(date)