生命科学综合责任保险投保申请书.doc

生命科学综合责任保险投保申请书 LIFE SCIENCE GENERAL LIABILITY INSURANCE APPLICATION FORM 请您务必在本表单项下充分、如实披露您所知晓的或应当知晓的所有信息，否则您将无权根据本保险合同获得任何受益。 YOU ARE TO DISCLOSE IN THIS FORM FULLY AND FAITHFULLY ALL FACTS WHICH YOU KNOW OR OUGHT TO KNOW, OTHERWISE YOU MAY RECEIVE NOTHING FROM THIS INSURANCE CONTRACT. 注意：这是一份以索赔发生并已通知为条件的保险的投保申请书。按本申请书的申请所签发的任何保险单项下的责任限额，根据保险单的相关定义，应包括对索赔的赔偿金和保险单所定义的理赔与答辩费用的给付。 NOTICE: This is an application for a claims made and reported policy and that the limit of liability under any policy to be issued in response hereto shall include both indemnity payments for claims and payment of claim and defense expenses, as defined in the policy. 请注意保单项下的答辩费用条款规定责任限额可因给付诉讼费用而用尽。任何免赔额或自留额均适用于赔偿金以及调查费用和答辩费用。 Please note that the defense cost provision of the policy stipulates that the limits of liability may be completely exhausted by the cost of legal defense. Any deductible or retention shall apply to investigation expense and defense costs as well as indemnity. 所有根据本投保申请书投保的个人或机构都应当如实、完整地回答本投保申请书项下的所有问题。对于不适用的问题或栏目，请用“不适用”回答。如果一个问题的答案是无，请写明“无”或者“0”。如果需要更多的空间填写问题的完整答案，请另以附页填写，并注明其所回答的问题。 ALL QUESTIONS IN THIS APPLICATION MUST BE ANSWERED TRUTHFULLY AND COMPLETELY FOR ALL PERSONS OR ORGANIZATIONS APPLYING FOR INSURANCE UNDER THIS APPLICATION. IF A QUESTION OR SECTION IS NOT APPLICABLE, PLEASE ANSWER NA. IF THE ANSWER TO A QUESTION IS NONE, STATE NONE OR 0. IF MORE SPACE IS REQUIRED TO ANSWER A QUESTION COMPLETELY, PLEASE PROVIDE A SEPARATE ATTACHMENT AND IDENTIFY THE QUESTION IT RESPONDS TO. 本投保申请书是一份word文档，投保人可以在相应的空白栏处填写信息，但请绝对勿对本投保申请书进行任何修改（除非为答案而保留的栏目）。本文件所设置的格式可以根据填入的内容而相应调整栏目的空间大小。在投保申请书每一主项的末尾都留有空白可加注详细的说明。 This application is a word document that allows applicant to enter information in the empty sections. Any alteration of this application (other than sections reserved for answers) is expressly prohibited. This document is configured so that each data entry section will expand to accommodate the information. A box for detailed commentary has been provided