"Vehicle Pre-shipment Condition Report Template - Veromarine"

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Vehicle Pre-Shipment Condition Report
To be completed by an independent party
Owner Details
Name
Address
in New Zealand
Telephone
Overseas
Telephone
Email
Shipping Details
Destination
on vessel
Date of shipment
/
/
Vehicle Details
Make of vehicle
Model
Year
Reg number
Engine number if no reg number
Condition of tyres (including spare)
Condition of upholstery/fittings
Specify any damaged glass
Battery disconnected
yes ~ no
(Please circle)
Radiator drained
yes ~ no
Item
Attached?
Remarks
Item
Attached?
Remarks
Spare tyres
Additional lights
yes ~ no
yes ~ no
yes ~ no
Stereo
Aerial(s)
yes ~ no
make & model
Ash trays
yes ~ no
Tool Kit
yes ~ no
Battery
yes ~ no
Clock
yes ~ no
List any non-standard accessories attached to the vehicle:
Floor mats
yes ~ no
Hub caps
yes ~ no
Keys
yes ~ no
List any appliances fitted in the caravan:
Monsoon
yes ~ no
Odometer reading
Petrol removed
yes ~ no
Household Goods & Personal Effects packed inside the vehicle are NOT COVERED
Declaration
We have inspected this vehicle and this report is our true assessment of its condition as at the date below.
Name of Company completing this report ____________________________________________________________________________
Name of individual completing this report __________________________________________Telephone ________________________
Signature ________________________________________ Date
/
/
Vero Marine Insurance, an operating division of Vero Insurance New Zealand Limited
VM671 11/08
PO Box 1759 Auckland
Tel: +64 9 363 2600
Fax: +64 9 363 2601
www.veromarine.co.nz
Vehicle Pre-Shipment Condition Report
To be completed by an independent party
Owner Details
Name
Address
in New Zealand
Telephone
Overseas
Telephone
Email
Shipping Details
Destination
on vessel
Date of shipment
/
/
Vehicle Details
Make of vehicle
Model
Year
Reg number
Engine number if no reg number
Condition of tyres (including spare)
Condition of upholstery/fittings
Specify any damaged glass
Battery disconnected
yes ~ no
(Please circle)
Radiator drained
yes ~ no
Item
Attached?
Remarks
Item
Attached?
Remarks
Spare tyres
Additional lights
yes ~ no
yes ~ no
yes ~ no
Stereo
Aerial(s)
yes ~ no
make & model
Ash trays
yes ~ no
Tool Kit
yes ~ no
Battery
yes ~ no
Clock
yes ~ no
List any non-standard accessories attached to the vehicle:
Floor mats
yes ~ no
Hub caps
yes ~ no
Keys
yes ~ no
List any appliances fitted in the caravan:
Monsoon
yes ~ no
Odometer reading
Petrol removed
yes ~ no
Household Goods & Personal Effects packed inside the vehicle are NOT COVERED
Declaration
We have inspected this vehicle and this report is our true assessment of its condition as at the date below.
Name of Company completing this report ____________________________________________________________________________
Name of individual completing this report __________________________________________Telephone ________________________
Signature ________________________________________ Date
/
/
Vero Marine Insurance, an operating division of Vero Insurance New Zealand Limited
VM671 11/08
PO Box 1759 Auckland
Tel: +64 9 363 2600
Fax: +64 9 363 2601
www.veromarine.co.nz
Indicate on the appropriate diagram the location, type and amount of damage
Please use the following abbreviations on the diagrams
B
Bent
LGC –
Locked glove compartment
BR
Broken
LRT –
Locked rear trunk
C
Chafed
M
Missing
CH
Chipped
RM
Rusty metal
D
Dented
S
Scratched
GC
Glass cracked
SCA –
Scratched and chafed all over
HDC –
Heavy dust & mud covered minor defects
SM
Smashed
If any, unable to determine
ST
Stained
HS
Hairline scratch
T
Torn
HSA –
Hairline scratches all over
Any other damage or defects
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