Producer Code.docVIP

Producer Code (Internal Use Only) — Producer Name (Internal Use Only) 投保单位资料Policyholder Information 投保 Name of Policyholder: 单位组织机构代码 Organizational Code Certificate: 办公地址 Business Address: 邮政编码 Postcode: 业务性质 Nature of Business:联络人 Contact Person: 联系电话 Contact Tel. No:传真号码 Fax No: 保险单资料Policy Information 保险期间Proposed Policy Period 由From: (年/月/日YYYY/MM/DD) 至To: (年/月/日YYY/MM/DD) 身故保险金受益人Beneficiary 继承人Estate of Insured Person 详见名册As per the Attached List 保险计划 Insurance Coverage: 项目 Basic Benefits 保险金额 (人民币) Sum Insured (RMB：yuan) 白银计划 Silver