COVER NOTE

In consideration if the Insured having agreed to pay the agreed Premium, the insurance as stated below is
provisionally accepted as from the date of acceptance for a period of Thirty (30) days in accordance with the
proposal made and subject to the terms and conditions of the Company’s usual form of Policy.

Date of Issue Policy Number

Cover Note Number CN234884 30-Sep-22 To Be Advised

Class of Insurance Machinery All Risk

Insured Name HSL Ground Engineering Pte Ltd

Period of Insurance 29-Sep-22 to 28-Sep-23 (Both dates inclusive)

1. Sany Hydraulic Excavator

Model: Sany SY215C
Serial Number: SY021NCCP1218
YOM: 2022
Country of Origin: China
Sum Insured: $120,000.00

2. Sany Hydraulic Excavator

Model: Sany SY215C
Serial Number: SY021NCCP1238
Interests Insured YOM: 2022
Country of Origin: China
Sum Insured: $120,000.00

3. Sany Hydraulic Excavator

Model: Sany SY215C
Serial Number: SY021NCCP1228
YOM: 2022
Country of Origin: China
Sum Insured: $120,000.00

ANYWHERE IN SINGAPORE BUT EXCLUDE WATERBORNE RISKS AND WORK

Situation of Risk
ONBOARD VESSELS

Total Sum Insured S$ 360,000.00

Excess As agreed

Terms, Conditions & Exceptions,

As agreed
Clauses, Extensions, Exclusions

Date of Acceptance 30-Sep-22

Signed For and On Behalf Of

HL Assurance Pte. Ltd.

_______________________
Authorised Signatory