How to fill in the occupational health examination service contract?

Occupational health examination agreement (service contract)

Customer (Party A):

Trustee (Party B):

Signing point:? Province, city (county)

Date of signature: year? Month? sun

Validity: year? Month? Year, month and day? sun

I. Signing of the Contract

According to the provisions of the Contract Law of People's Republic of China (PRC), both parties to this contract sign this agreement (contract) on the occupational health examination service for workers (by the employing unit) through consultation.

Two. Basis, scope and content of occupational health examination

According to the requirements of laws, standards and norms such as Administrative Measures for Occupational Health Surveillance, Technical Specifications for Occupational Health Surveillance, etc., conduct occupational health examination for the workers exposed to occupational hazards by the entrusting party. For details, please refer to the Annex List of Occupational Health Examiners, Items and Expenses.

Three. When Party A submits relevant technical documents to Party B,

After the contract comes into effect, Party A must? Provide necessary information for occupational health examination according to the requirements of Party B within days. (Tick below)

Basic information of the employer □

Types of Occupational Hazards in Workplace and Number of Contacts □

Concentration or intensity data for monitoring occupational hazard factors □

Production technologies, processes and materials that cause occupational hazards □

Occupational hazard protection facilities, emergency rescue facilities and other related information □

Four. Number of copies and time when Party B delivers the occupational health examination report to Party A.

Where is Party B? Provide Party A with the personal occupational health check list of all the inspected personnel, and provide a copy of the occupational health check report.

Verb (abbreviation for verb) fee and payment method

(a) the cost of this project

Based on Anhui price. In 2007 17 and Anhui Medical Service Price Manual, both parties agreed to pay the occupational health examination fee according to the actual expenses, totaling RMB.

(II) Mode of payment

Adopt installment/lump sum payment.

What's the percentage of the total installment fee? RMB Yuan only, paid in full as deposit. The other% is RMB only, which shall be paid when the occupational health examination report is delivered. Pay in one lump sum when the occupational health examination report is delivered.

The responsibility of both sides of intransitive verbs

(I) Party A's responsibilities

1. Party A must provide Party B with the necessary information for occupational health examination within the time specified in Article 3 of this contract, fill in the basic information of the inspected person in the occupational health checklist, be responsible for the completeness, authenticity, validity and correctness of the information, and confirm the identity of the inspected person. Party A shall not require Party B to have an occupational health examination in violation of relevant national standards.

If the technical documents submitted by Party A exceed the specified time limit, the time for Party B to submit the occupational health examination report shall be postponed according to the delivery time specified in Article 4 of this contract.

2. When Party A pays the health examination fee in installments, it must pay the down payment as agreed in the contract. If the deposit is not received, Party B has the right to postpone the start of the occupational health examination and submit the occupational health examination report.

3. After the signing and performance of this contract, Party A requests to terminate or dissolve this contract, and Party B will not refund the deposit paid by Party A. ..

4. Party A determines 1 contact person (or group) to cooperate with Party B; Make sure that 1 the person who can replace the legal representative is responsible for signing and confirming the documents of both parties.

Contact:? Telephone:?

Signed by? Telephone:?

(II) Party B's responsibilities

1. Party B shall carry out the occupational health examination in accordance with the relevant technical standards and specifications stipulated by the state, and deliver the occupational health examination report to Party A according to the time, place and quantity specified in Article 4 of this contract "(1), (1) and (2) of this Article."

2. After this contract comes into effect, if Party B requests to terminate or dissolve this contract, Party B shall double the deposit paid by Party A.. ..

3. Party B shall identify 65,438+0 contacts (or groups) to keep in touch with Party A; Make sure that 1 the person who can replace the legal representative is responsible for signing and confirming the documents of both parties.

Contact:? Contact telephone number:

Signed by? Contact telephone number:

Seven. responsibility for breach of contract

(1) If Party A refuses to accept the occupational health examination or fails to accept the occupational health examination within the time limit, it will not recover the paid fees and pay the unpaid fees in addition to assuming the responsibilities according to the terms of the deposit.

(2) If Party B fails to complete the occupational health examination and submit the occupational health examination report on time, it shall reduce the occupational health examination fee. Quotas shall be negotiated and signed by both parties.

(3) If either party breaches the contract and causes economic losses to the other party, it shall compensate for the economic losses.

Eight. Ways to solve contract disputes

Disputes arising from the performance of this contract shall be settled by both parties through negotiation in time, or through mediation by the local competent department. If negotiation and mediation fail, either party has the right to bring a lawsuit to the people's court.

Nine. Privacy Policy

All information provided by Party A to Party B and the results of occupational health examination of Party A's personnel shall not be disclosed by Party B to any third party except the examinee himself.

X. Other terms that need to be explained

(1) If Party A wants Party B to undertake the work services beyond this contract, it shall sign a separate agreement and pay the fees.

(2) If the contract cannot be performed due to force majeure, both parties shall settle it through negotiation in time.

(3) This contract shall come into effect as of the date of signature and seal by both parties, and it shall be made in duplicate, with each party holding one copy.

(4) Faxes and telegrams recognized by both parties can be used as an integral part of the contract and have the same legal effect as this * * * *.

(V) For matters not covered, both parties shall sign a supplementary agreement through negotiation, and the supplementary agreement shall have the same effect as this contract.

(six) a contract that is only stamped with the seal of the unit contract without the signature of the legal representative of the unit or its entrusted agent is invalid. Under special circumstances, a contract signed by the legal representative of the unit or its entrusted agent without the seal of the contract shall be deemed as valid as long as it is signed on every page of the contract.

Principal (seal): Trustee (seal):?

Legal representative (signature): Legal representative (signature):

Authorized Agent (signature): Authorized Agent (signature):

Year? Month? Day? Year? Month? sun