合同编号:____________
甲方:_______________________________
法定住址:___________________________
法定代表人:_________________________
职务:_______________________________
委托代理人:_________________________
身份证号码:_________________________
通讯地址:___________________________
邮政编码:___________________________
联系人:_____________________________
电话:_______________________________
电挂:_______________________________
传真:_______________________________
帐号:_______________________________