雇主责任险风险问卷调查表.doc

雇主责任保险 Employer’s Liability Insurance 风险调查问卷 Risk Evaluation Questionnaire 概 况General Information 1．投保人名称Name of Insured ____________________________________________________________________________________________________________ 2．总部地址Address of Head Office in P.R.China ____________________________________________________________________________________________________________ 3．工作地点Work-place (若包含多个附地址清单If more than one place are included, please attach list) ____________________________________________________________________________________________________________ 4．企业性质Nature of Enterprise □国营state-owned □集体collective □私营private-owned □股份制shared □中外合资joint □外商独资，请告知外方的国籍：foreigner-owned, please advise nationality of the owner ____________________________________________________________________________________________________________ 5．行业性质与经营范围Nature Scope of Business 是否属于危险品生产Is your business to manufacture hazardous products？ □是Yes □否No 请详述：Please describe ____________________________________________________________________________________________________________ 6．普通汽车数量Number of regular automobiles：___________________________________________________________________________ 是否拥有特种工程车？Do you possess engineering vehicles for specialized operation □是Yes □否No 若有，请说明：If so, please specify 车辆类型type 数 量quantity ___________ ___________ ___________ ___________ ___________ ___________ 雇员情况condition of employee 1．员工人数No. of Employee: ___________ 其中，人事/人力资源部员工数Amidst above, No. of Employees in the personnel/human resource department: _________________ 女性员工占比Percentage of Female Employee：