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1、律师职业责任保险-投保书SOLICITORS9PROFESSIONALLIABILITYINSURANCE一PROPOSAL•本投保书必须经rh投保人授权的主任、合伙人及管理人的确认、签章并注明H期。Thisproposalmustbereviewed,signed,stampedanddatedbyadulyauthorizedPrincipal,PartnerorDirector.•请回答该表中的所有问题。若填写位置不足,请另附公司信纸作答。Youmustanswerallthequestionsinthisfoim
2、.Ifmorespaceisrequiredtoansweraquestion,continueonyourletterhead・•签署木投保书并不代表投保人购买木保险合同SigningthisproposaldoesnotbindtheApplicanttocompletethisinsurance.有关投保人的资料DetailsofApplicant1.律师事务所名称NameoftheLawFirm地址PrincipalAddress联系人ContactPerson电话号码传真号码TelephonenumberFax
3、number电邮地址网址E-mailaddressWebsite2.贵所成立时间Whenwasyourfirmestablished?3.贵所是否曾更名或曾收购、合并其它律师事务所或其它业务?Hasyournameeverbeenchanged,orhaveyoupurchasedormergedwithanyotherpracticeorbusiness?□是Yes□否No若有,请另附公司信纸提供详细信息,包括该被并购方的名称、并购时间、新增律师的数忖及被并购业务的收入情况。Ifyes,pleaseattachdeta
4、ilsincludingthenameofanypracticeofwhichthisPracticeisasuccessor,thedateofsuchtransaction,thenumberofsolicitorsemployedandthefeeincomeofthepreviouspractice1.请说明贵所各分支机构及职责(如需要包含于承保范围屮的)Pleaselistanybranchofficc(s)(forwhichcoverisrequired)togetherwithdetailsofthePar
5、lncr(s)responsibleforeachone2.贵所以下成员人数:Whatisthenumberofyour:主任、副主任、合伙人及管理人Principals,DeputyPrincipals,partnersordirectors律师Lawyers咨询师Consultants实习律师LocumPractitioners法律助理LegalAssistants其他工作人员Otherstaff合计Total3.请提供贵所主任、副主任、合伙人、管理人及其他主要专业人员的资历Whatarethequalificati
6、onsofyourPrincipals,DeputyPrincipals,Partners,Directorsorotherkeyprofessionalpersonnel?姓名Name执业资格Qualifications获得资格年份YearQualified在贵所担任主任、副主任、合伙人或管理人的年资YearasPrincipal,DeputyPrincipal,PcirtnerorDirectorofThisPractice在其它律所担任主任、副主任、合伙人或管理人的年资YearasPrincipal,DeputyP
7、rincipal,PartnerorDirectorofPreviousPractice有关业务的资料7.DetailsoftheBusiness请提供贵所本年度及上一年度的总收入Pleaseprovideyourtotalfeeincomeofthecurrentyearandthepastyear:木年度(预测)Currentyear(est)上一年度Pastyear8.贵所本年度及上-•年度涉外业务收入的比例。涉外业务指包含海外公民、海外注册的实体、海外诉讼标的或海外当事人因素的业务。就本提问而言,“海外”包括港、
8、澳、台。Whatarethepercentagesofthetotalfeeincomeofthecuirentyearandthepastyearcomingfromforeignbusiness?Foreignbusinessmeansbusinesscomesfromanoverseascitizenorreg