甲方:__________________(盖章)乙方:_______________________(盖章)
法定代表人签字:________________法定代表人签字:_____________________
(委托代理人):________________(委托代理人):_____________________
地址:__________________________地址:_______________________________
邮编:__________________________邮编:_______________________________
电话:__________________________电话:_______________________________
传真:__________________________传真:_______________________________
开户银行:______________________开户银行:___________________________
开户银行账号:__________________开户银行账号:_______________________
纳税人登记号:__________________纳税人登记号:_______________________
签订日期:_______年____月_____日签订地点:___________________________