出口产品责任险投保申请书.pdf

出口产品责任险投保资料 EXPORT PRODUCTS LIABILITY INSURANCE APPLICATION 本公司对问卷各项填写内容，除作为核保及其它保险程序上的参考外，不另为其它用途，并予以保密。 The information provided here will be used for insurance underwriting and related processing only, and will be kept confidential. Part I –基本信息 Basic Information 1. 投保人 /被保险人名称及注册地址 Name address of applicant /insured (including all subsidiaries): 2. 被保险人成立形式 The Legal Form of the Insured 独资 Individual _________ 合伙 Partnership _________ 公司 Corporation __________ 合资 Joint venture________ □ □ □ □ 3. 请选出被保险人的经营性质 Please tick the business nature of the Insured: 制造商 Manufacturer __________ 经销商 Distributor _________ 贸易公司 Trading Company _________ □ □ □ □其它(请说明 ) other (please state) _________________ 4. 投保公司从事该行业几年？如果有的话，请提供公司网址 How long has the Insured been in this business? Please provide company web address, if there is one. 5. 被保险人在美国或加拿大有分支机构或代表处？ 如有 , 请提供以下资料 Does the Insured have any subsidiaries, affiliates or representative office in the USA and/or Canada? If YES, please give the following details: □ No 公司名称 Name of Company: _______________________________________________ 公司性质 Business Nature: _________________________ ___________________ 地址 Address: ______________________________________________ _________ 与被保险人关系 Relationship with the Insured: _____________ ___ PARTII - 产品信息 PRODUCT(s) INFORMATION ( 请附产品说明书、产品目录、测试报告、用户使用手册。 Please attach Product Brochures, Catalogue, Testing Reports, User Manuals) 1. 1 ）请简要说明贵公司目前所生产或销售的所有产品