出口产品责任险投保单（5页）.pdf

*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.