出口产品责任险投保单(5页).pdf
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*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.

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