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中国人民保险公司机动车辆投保单(样式二)

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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN" "http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd"><html xmlns="http://www.w3.org/1999/xhtml"><head><meta http-equiv="Content-Type" content="application/xhtml+xml; charset=utf-8" /><title></title><style type="text/css">body{ font-family:'Times New Roman'; font-size:1em; } ul, ol{ margin-top: 0; margin-bottom: 0; } ins{color:#2E97D3;} del{color:#FF0000;} .Normal{page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-top:0.0pt;margin-bottom:0.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:12.0pt;font-family:'Times New Roman';mso-fareast-font-family:'Times New Roman';mso-bidi-font-family:'Times New Roman';} .Default-Paragraph-Font{font-family:'Times New Roman';mso-fareast-font-family:宋体;mso-bidi-font-family:'Times New Roman';} .Normal-Table{} .Table-Grid{} .Table-Normal{} </style></head><body style="pagewidth:595.3pt;pageheight:841.9pt;"><div class="Section0"><div style="min-height:72pt" /> <p class="Normal" style="text-align:center;line-height:22.0pt;"><span style="color:#000000;font-size:16.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-weight:normal;">中国人民保险公司机动车辆投保单</span></p> <p class="Normal" style="text-align:center;line-height:22.0pt;"><span style="color:#000000;font-size:12.5pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-weight:normal;">&nbsp;&nbsp;</span><a id="_GoBack" /></p> <p class="Normal" style="text-align:center;line-height:22.0pt;font-size: 12.5pt;"><span style="color:#000000;font-size:12.5pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-weight:normal;">&#xa0;</span></p> <p class="Normal" style="text-align:left;line-height:22.0pt;"><span style="color:#000000;font-size:12.5pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-weight:normal;">  投保人____                   编号:</span></p> <table cellspacing="0" style="border-collapse: collapse; width: 488.8pt; "><tr style="height: 42.0px"><td rowspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">车辆型号</span></p> </td><td rowspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">牌照号码</span></p> </td><td rowspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">用途</span></p> </td><td rowspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">吨位或座 位</span></p> </td><td colspan="5" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">第三者责任险</span></p> </td><td rowspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">保险费合计</span></p> </td></tr><tr style="height: 42.0px"><td style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">保险金额</span></p> </td><td style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">费率</span></p> </td><td colspan="2" style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">保险费</span></p> </td><td style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">基本保险 费</span></p> </td><td style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">固定保险 费</span></p> </td></tr><tr style="height: 22.0px"><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td colspan="2" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#000000;border-top-width:0.67px;border-left-style:solid;border-left-color:#000000;border-left-width:0.67px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.2px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td style="vertical-align:middle;background-color:#FFFFFF;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;width:59.26667px;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" rowspan="13" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">总保险金额:人民币 </span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">地 址:        </span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">电 话:        </span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">联系人:        </span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">开户银行:       </span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">帐 号:        </span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">单位签章: </span></p> </td></tr><tr style="height: 21.0px"><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 22.0px"><td colspan="7" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">保险费总额:人民币</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">经办人:  </span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" style="vertical-align:middle;background-color:#F9F9F9;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">        自 年 月 日  时起</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">年 月 日</span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">保险期限: 个月</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 18.666666px"><td colspan="7" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 22.0px"><td colspan="7" style="vertical-align:middle;background-color:#F9F9F9;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">        至 年 月 日二十四时止</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" style="vertical-align:middle;background-color:#FFFFFF;border-top-style:solid;border-top-color:#666666;border-top-width:1.33px;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;lang:EN-US;mso-fareast-language:ZH-CN;mso-ansi-language:X-NONE;font-style:normal;">备注:(1)(务请注明保额来源及计算方式):</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 18.666666px"><td colspan="7" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 20.0px"><td colspan="7" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr><tr style="height: 22.0px"><td colspan="7" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#000000;border-right-width:0.67px;border-bottom-style:solid;border-bottom-color:#666666;border-bottom-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="text-align:left;font-size: 12pt;"><span style="color:#333333;font-size:12.0pt;font-family:黑体;mso-fareast-font-family:黑体;mso-bidi-font-family:黑体;font-style:normal;">&#xa0;</span></p> </td><td colspan="4" style="vertical-align:middle;background-color:#FFFFFF;border-left-style:solid;border-left-color:#666666;border-left-width:1.33px;border-right-style:solid;border-right-color:#666666;border-right-width:1.33px;border-bottom-style:solid;border-bottom-color:#666666;border-bottom-width:1.33px;padding-left:0.75pt;padding-right:0.75pt;padding-top:0.75pt;padding-bottom:0pt;"><p class="Normal" style="font-size: 11pt;"><span style="color:#000000;font-size:11.0pt;font-family:宋体;mso-fareast-font-family:宋体;mso-bidi-font-family:宋体;font-style:normal;">&#xa0;</span></p> </td></tr></table><p class="Normal" style="font-size: 12pt;"><span style="font-size:12.0pt;font-family:'Times New Roman';mso-fareast-font-family:'Times New Roman';mso-bidi-font-family:'Times New Roman';">&#xa0;</span></p> </div></body></html>

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