雇主责任险风险问卷调查表.doc

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1、雇主责任保险风险调查问卷Employer^LiabilityInsuranceRiskEvaluationQuestionnaireM况GeneralInformationI・投保人名称NameofInsured2.总部地址AddressofHeadOfficeinP.R.China3.工作地点^^k-placc(若包含多个附地址清单Ifmorethanoneplacearcincluded・pleaseattachlist)4.企业性质NaiurcofEnterprise□国营state-owned□集体collective□私营private-owne

2、d□股份制shared□中外合资joint□外商独资，请告知外方的国藉：foreigner-owned,pleaseadvisenationalityoftheowner5.行业性质与经营范围Naiure&ScopeofBusiness是否属于危险品生产Isyourbusinesstomanufacturehazardousproducts?□是Yes□否No请详述：Pleasedescribe6.普通汽车数莹Numberofregularautomobiles:是否拥有特种工程车？Doyoupossessengineeringvehiclesforspe

3、cializedoperation□是Yes□否No若有，请说明：Ifso,pleasespecify车辆类型type数#quantity雇员情况conditionofemployeeI・员工人数No.ofEmployee:其中，人事/人力资源部员工数Amidstabove.No.ofEmployeesinthepersonnel/huinanresourcedepartment:女性员工占比PercentageofFemaleEmployee:%30岁以下员工占比PercentageofEmployeebelow3():%30-50岁员工占比Percen

4、tageofEmployeebetween30and50:%50岁以上员工占比PercentageofEmployeeover50:%2.是否为本单位雇员缴纳四金？Doyoupaytolegalwelfarefundsforallofyouremployees□是Yes□否No除本保险外，是否还为雇员购买其他商业保险？Isthereanyotherwelfarecommercialinsurancepolicypurchasedforyouremployeebesidesthisinsurance□是Yes□否No请简单评述本单位的福利和收入水平在同行业中

5、的所处地位：Pleasegivecommentinrespectofyouremployeewelfareandsalary□领先superior□高于平均水平aboveaverage□一般水平average□低于平均水平belowaverage3・请按下表填写雇员的情况：Pleasefillinthefollowingblank雇员工种人数平均年收入是否需出差ClassificationNumberofAveragewage&BusinesstripOfWbrkEmployeeotherearningsyearlyFrequently?□是Yes□是Y

6、es□是Yes□是Yes□是Yes□是Yes□是Yes□否No□否No□否No□否No□否No□否No□否No□是Yes□是Yes□否No□否No□是Yes□是Yes□是Yes□是Yes□是Yes□是Yes□否No□否No□否No□否No□否No□否No行业风险防范LossControl1.是否设有安全生产管理部门Doyouhiivcspecialdepartmentdealingwiththemanagementofsafetyproduction?是否有安全检查制度并得到能切实的落实Areallinspectionsystemsforthepurpos

7、eofsafetyfullyimplementedandperformed?2.员工是否经过专业技术培训Haveallofyourstaffbeentrainedinprofessionaltechniquecourses?员工是否能連守各项制度和纪律Couldyourstaffobligeallthedisciplinesandsystemmadebythemanagementboard?3・生产过程中是否有特殊危险的作业Isthereanydangerousoperationinvolvedinthecourseofproduction?若冇，请说明危

8、险的来源IfYes,pleaseadvise(hesourceof