药品零售企业经许可和认证申请表(表4).doc

附件2: 药品零售企业经营许可和认证申请表 企业名称： 隶属单位： 联 系 人： 联系电话： 填报日期： 年 月 日 重庆市食品药品监督管理局制 填报说明 1、内容填写应准确、完整，不得涂改和复印。 2、报送申请表时，应附有关材料： （1）工商行政管理部门出具的拟办企业核准证明材料。 （2）从业人员的身份证、执业药师注册证书、专业技术职称证书和学历证书的复印件；劳动聘用合同。 （3）营业场所、仓库平面布置图及房屋产权证、房屋租赁合同等复印件。 （4）药品经营场所及设施设备发票等购置证明材料。 3、凡申请企业申报材料时，申请人不是法定代表人或负责人本人，企业应当提交《授权委托书》。 4、申请书以及其他申报资料，应统一使用A4型纸张，标明目录及页码并装订成册。 申请企业基本情况表 企业名称 经营地址 法定代表人 学历 执业药师 或技术职称 企业负责人 学历 执业药师 或技术职称 质量负责人 学历 执业药师 或技术职称 经营范围 药品经营面积（㎡㎡ implementation of corrective tasks for the new problems found in a timely manner into the special rectification and rectification category. In-depth summary of good practices and good experience in educational practice, good around the typical, continue to promote the rectification, to prevent repeated rebound, use of the results of the activities, timely organization look back again. The theoretical results, continuously consolidate and deepen and expand educational practice to achieve the system results, practical results. Three, the main problems and rectification measures focus on rectification goals, determined to honor the commitment rectification measures to build long-term mechanism style construction bureau Party, improve the ideological style The construction and working level, according to the list of issues to sort it out, with overall requirements to carry out the mass line of educational activities, focus on the implementation of the rectification, enhance team ability to discover and solve their own problems, focus on building a political firm, pioneering and innovative, wholeheartedly for the people, strive for unity, harmony, strong collective leadership (a honest and clean.) there lack of global awareness and innovation problem in carrying out the democratic centralism of the party. The party will discuss the main points of the 2014 Bureau o