第1页共7页编号：时间：2021年x月x日书山有路勤为径，学海无涯苦作舟页码：第1页共7页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(includingallsubsidiaries):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)_________________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:_______________________________________________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。PleaseattachProductBrochures,Catalogue,TestingReports,UserManuals)第2页共7页第1页共7页编号：时间：2021年x月x日书山有路勤为径，学海无涯苦作舟页码：第2页共7页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?Howmanyyearshaveyoubeenmanufacturingordistributingtheseproducts?______________________________________________________________________________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Arethereanyproductsthatarenolongermanufacturedordistributedbyyouduringthepastfive□YES□NOyears?IfYES,pleasedescribe.4.未来一年内是否预计推出新的产品？如有，请说明。Areanynewproductsproposedforintroductionduringtheensuingyear?IfYES,pleasespecify:□YES□NO*请注意：任何新增加的产品必须通知本公司,并经本公司书面同意后才能受本保险保障。*Note:AnyadditionalproductmustbereportedtotheCompanyandwillbecoveredonlyuponwrittenacceptancebythecompany.5.产品是否全部由贵公司自行设计?Areallofyourproductsdesignedbyyourself?□YES□NO6.贵公司的产品是否作为其它产品的零组件?若是，请指明Arethereanyproductssoldascomponentpartsforotherproducts?IfYES,pleasespecify:□YES□NO7.1）贵公司所售的产品是否有以其它名称来销售?如有，请说明并提供其所占比例。Areanyofyourproductssoldunderanothernameorlabel?IfYES,pleasedescribeandgive□YES□NOPercentage.__________________________________________________________________2）如有，请问此产品是由贵司设计还是买方设计？□YOURCOMPANYAresuchproductsmadetoyourspecificationorthoseofthebuyer?□BUYER第3页共7页第2页共7页编号：时间：2021年x月x日书山有路勤为径，学海...
