编号:FS-HT-05018
雇主责任险保险合同Employer's liability insurance contract
甲方:________________________
乙方:________________________
签订日期:_____年____月____日
编订:FoonShion设计
雇主责任险保险合同
1.雇主责任险保险单
EMPLOYER"SLIABILITYINSURANCEPOLICY
保险单号码
PolicyNo.
中保财*保险有限公司(以下简称本公司)按照背面所载条款的规定,在本保险单保险期内,承保下述雇主责任险,特立本保险单。
ThisPolicyofInsurancewitnessestheThePeople"sInsuranc e(Property)CompanyofChina,
L*d.(hereinaftercalledTheCompany")undertakestoinsure againstEmployer"sLiabilityInsurance
duringtheperiodoftheInsurancesubjecttotheClausesprint
edoverleaf.
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||姓名|
||Name:|
||---------------------------------------||投保人|地址|
|TheApplicant|Address:|
||---------------------------------------|||营业性质|
||Trade/Occupation:|
|---------|---------------------------------------|
|地区范围||
|GeographicalArea||
|---------|---------------------------------------|
|保险期限|个月自零时至二十四时止|
|Insuredperiod|month(s)from00:00ofto24.00hourof|
|---------|---------------------------------------|
||雇员工种|||||||总计|
||Employees"||||||||
||Occupation|||||||Total|
||-----------|---|---|---|---|---|---|---|||估计雇员人数||||||||
|雇员一览表|Est.number||||||||
|Scheduleof|ofEmployees||||||||
|Employees|-----------|---|---|---|---|---|---|---|
||估计工资及其他收入总数||||||||||TotalEst.||||||||
||Wages&other||||||||
||allowances||||||||
|---------|---------------------------------------|
|||赔偿限额|费率|保险费|
|||LimitofIndemnity|Rate|Premium|
|雇主责任险|----------|-----------|-------|--------|
|Employer"s|死亡Death||||
|LiabilityCover|----------|-----------|||
||伤残Injury||||
||----------|-----------|||
||||||
|---------|----------------------|-------|--------|
|附加医药费保险|每人累计不超过||||
|Add.Medical|Nottoexceedinaccumulation||||
|Exp.cover|foranyoneperson||||
|---------|---------------|------|-------|--------|
|第三者责任险|累计每次事故||||
|T.P.Cover|inaccumulationa.o.a.||||
|-------------------------------------------
------|
|保险费总数(预付)|
|TotalPremium|
|(Paidinadvance)|
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||签字:|
|投保人对保险人的除外责任条款明确无误||||Signature:|
|I,theapplicant,certifythatIfully||
||日期:_____年___月___日|
|understandtheexclusionclauseshereof.||
||date:///|
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