产品责任险风险问卷及投保单

1. 投保人名称及地址 Name and Address of Proposer 2. 被保险人名称及地址 Name and Address of the Insu red 3. 被保险人电话及邮编 Telephone No. and Post Code of the Insu red 4. 被保险人营业性质 Natu re of Bu siness of the Insu red 制造商（ ） 零售商（ ） 批发商（ ） 进口商（ ） 出口商（ ） Manu factu rer Retailer Wholesaler Importer Ex porter 5. 保险产品的情况 Description of Insu red Produ cts 名称 种类 性质 直接及间接用途 销售额 销售范围 Description Ty pe Natu re Direct & Indirect Use Sales Volu me Sales Area 合计 Total 6. 投保人工厂，商店或仓库的所在地 Location of Insured’s factory, shop or warehouse 7. 有无其他分支机构 Is there any other su bsidiary 有（ ） 无（ ） Yes No 如果有，请列明地址和销售额 If so, please state the address and sales v olu me 产品责任险风险问卷及投保单 Questionnaire and Proposal for Products Liability Insurance 8. 投保产品的平均使用寿命 The average life expectancy of the products insured 9. 投保产品的销售历史 Sales record a) 美国/加拿大的产品U.S.A. / Canada Products 请告知过去五年及预估未来年度，贵公司外销美加地区的各项产品销售额 List all products manufactured, sold or distributed by Applicant in or exported to U.S.A./Canada and sales by product for the last 5 years as well as estimated sales for the upcoming year (attach product brochures or other printed material describing products). b) 其余地区的产品Rest of the World Sales of Products 请告知过去五年及预估未来年度，外销其余地区（不包括美国/加拿大）的各项产品销 售额 List all products manufactured, sold or distributed by Applicant in or exported to Rest of the World (excluding U.S.A./Canada/) and sales by product for the last 5 years as well as estimated sales for the upcoming year (attach product brochures or other printed material describing produ...