外销产品责任险要保书.docVIP

出口产品责任险投保书 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: □ Yes □ 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, 并说明所需承保的产品。 Please list all products produced and/or distributed by you and specify the products to be insured. ______________________________________________________________________________ 2）贵公司从事生产或销售这些产品多长时间? How many years have you been manufacturing or distributing these products?