承包商预先资格审查表.pdfVIP

Contractor prequalification questionnaire 承包商预先资质审核调查表 CONTRACTORS NAME 承包商名称______________________DATE 日期______________ ADDRESS 地址________________________________________________________________ 1. Please consolidate your firms injury data for the last three years and complete the following: 请把贵企业最近三个年度的工伤数据汇总后，完成以下内容： YEAR 年: 2014 2015 2016 a) Number of injury incident without lost workday 无损失工作日伤害事故数量 _____ _____ ______ b) Number of Light Injury Incident 轻伤事故数量 _____ _____ ______ c) Number of Serious Injury Incident 重伤事故数量 _____ _____ ______ d) Number of Fatality Incident 死亡事故数量 _____ _____ ______ e) Number of Significant Fatalities Incident 重大死亡事故数量 _____ _____ ______ f) Total number of company work hours 公司全部工作小时合计 _____ _____ ______ g) Total number of lost workdays 全部损失工作日合计 _____ _____ ______ 2 ． Do you maintain the following insurance as required by the Chinese Insurance Requirements. 根据中国保险的要求，参保以下的险吗？  Construction all Risk Liability Insurance Y 是/ N 否 Amount 金额____________ 施工一切险  Third Party Liability Insurance Y 是/ N 否 Amount 金额____________ 第三者责任险  Employer Liability Insurance Y 是/ N 否 Amount 金额___________ 雇主责任险  Accident Insurance Y 是/ N 否 Amount 金额___________ 人身意外保险 3. List any fatalities your firm has had in the last three years. Include location, cause and corrective act