[精品]公众责任保险风险问卷调查-公共场所

《[精品]公众责任保险风险问卷调查-公共场所》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、公众责任保险风险调查问卷□大卖场/超市/百货商场shoppingmall/supermarket/departmentstore:是否设有儿童游乐区Arepleasuregroundforchildrenincluded?是否有铺位或柜台向第三方出租Arethereanybusinessareasleasedtothirdparties?□商务楼/公寓businessofficc/apartmcnt□公园/游乐场park/amusementcentre□医院/诊所hospital/clinic□宾馆hotel:是否是星级宾馆，多少星级No.ofStarsifyouare

2、qualified?若上述场所含有以下服务内容，则也须选择和回答Pleasecompletetherestpartifyouprovidetheservicesasdescribedbelow:□饭店/餐厅rcstaurant/snackbar□旱地溜冰场skatingrink:请告知何种地面pleaseadvisewhatkindofground:□舞厅、卡拉OKdiscoroom,karaokeprivate:是否供应酒精度超过15的饮料Doyouprovidebeveragewithalcohollevelabove15degree?□是Yes□否No□酒吧pub

3、□影剧院、放映厅cinema/theatre□游泳馆/池swimmingpool:换水频度frequencyofchangingwater?采用何种措施保证水质waytoguaranteequalityofwater?□健身中心fitnessclub:有无配备专业教练指导Instructedbyprofessionals?器材定期保养维护regularmaintenanceonequipment?□美容中心beautyparlor&/orhairdresser□沐浴中心bathe&sauna□网球场tenniscourt:是否禁止儿童进入场地Arechildallowe

4、dinthepremise?□是Yes□是Yes□否No□否No值班救生员人数No.oflifeguard?□是Yes□是Yes□是Yesn否□否No□否NoPublicLiabilityInsuranceRiskEvaluationQuestionnaire本表适用于公共场所的场所公众责任险投保。TliisformshallbeappliedtoonpremisecoverofPublicLiabilitvInsuranceforpublicplace.概况GeneralInformation1・投保人名称NameofInsured2.总部地址AddressofHea

5、dOfficeinP.R.China3.企业性质NaUireofEnterprise□国营slate-owned□集体collective□私营private-owned□股份制shared□机关事业government□中外合资joint□外商独资，请告知外方的国籍:foreigner-owned,pleaseadvisenationalityoftheowner4.保险地址LocationunderCover（连锁店请附地址清单Pleaseattachlistifyouareoperatingachainfirm）5.请在左栏选择被保险人所经营管理的场所的主要性质，

6、然后选择或回答对应的右栏中的有关问题・Pleasemakechoiceonthelefthandsidefirst,then,ifapplicable,ch（x）seYesorNooranswertherelevantquestionontherighthandside.□离尔夫球场golfcourt□游艺厅gameroom:请说明主要活动项目pleasespecifymajorproject是否主要面向儿童开放mainlytowardchildren?□是Yes□否No□停车服务parkingservices:是机械化立体库Doyoumanageamechanical

7、hangar?□是Yes□否No□综合娱乐总汇nightclub□其他others:请具体说明pleasespecify6.员工总人数NoofStaff:,其中保安员人数Noofsecuritystaffamidst:,汽车数量No.ofvehicle:7.营业/活动场所面积businessareainsquaremeters:m28.过去12个月的营业收入turnoverduringthelast12months:,开业日期dateofopening:9.平均客流情况averagenumberofvisitors:（例如：月均客流量二门