外销产品责任险要保书

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1、出口产品责任险投保书EXPORTPRODUCTSLIABILITYINSURANCEAPPLICATION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。Theinformationprovidedherewillbeusedforinsuranceunderwritingandrelatedprocessingonly,andwillbekeptconfidential.PartI–基本信息BasicInformation1.投保人/被保险人名称及注册地址Name&addressofapplicant/insured(includingallsubs

2、idiaries):2.被保险人成立形式TheLegalFormoftheInsured□独资Individual_________□合伙Partnership_________□公司Corporation__________□合资Jointventure______3.请选出被保险人的经营性质PleasetickthebusinessnatureoftheInsured:□制造商Manufacturer__________□经销商Distributor_________□贸易公司TradingCompany_________□其它(请说明)other(pleasestate)________

3、_________4.投保公司从事该行业几年？如果有的话，请提供公司网址HowlonghastheInsuredbeeninthisbusiness?Pleaseprovidecompanywebaddress,ifthereisone.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DoestheInsuredhaveanysubsidiaries,affiliatesorrepresentativeofficeintheUSAand/orCanada?IfYES,pleasegivethefollowingdetails:□Yes□No公司名称NameofCompany:

4、_______________________________________________公司性质BusinessNature:____________________________________________地址Address:_______________________________________________________与被保险人关系RelationshipwiththeInsured:________________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。PleaseattachProdu

5、ctBrochures,Catalogue,TestingReports,UserManuals)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。Pleaselistallproductsproducedand/ordistributedbyyouandspecifytheproductstobeinsured.______________________________________________________________________________2）贵公司从事生产或销售这些产品多长时间?Howmanyyearshaveyoubeenmanufact

6、uringordistributingtheseproducts?______________________________________________________________________________2.预期产品的生命期限Whatisthelifeexpectancyofyourproduct?_______________________________________________________________________________3.最近五年内是否有已停止生产或销售的产品？如有，请简要说明Arethereanyproductsthatarenolong

7、ermanufacturedordistributedbyyouduringthepastfive□YES□NOyears?IfYES,pleasedescribe.Page5of53.未来一年内是否预计推出新的产品？如有，请说明。Areanynewproductsproposedforintroductionduringtheensuingyear?IfYES,pleasespecify:□YE