赔偿责任解除书(样本)

航空发表于 2010-4-14 18:44:09

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10作3-39                                                       存档编号：<o:p></o:p>
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本人/公司同意并愿意接受航空有限公司对货运单______________项下货物丢失/破损/延误的赔偿。赔偿金额为______________元人民币。<o:p></o:p>
在收到上述赔款的同时放弃对云南航空有限公司及其相关的航空承运人、代理人、工作人员和其他相关利益方的追索权。<o:p></o:p>
同时，同意不再就以上货物相关的事项对航空有限公司提起法律诉讼。<o:p></o:p>
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索赔人签名：________________ 地点：_____________ 日期：____________<o:p></o:p>
                  (签名后请按拇指印)<o:p></o:p>
<o:p> </o:p>
      作证人签名：                  地点：_____________ 日期：____________<o:p></o:p>
                  (签名后请按拇指印)<o:p></o:p>
<o:p> </o:p>
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RECEIPT AND RELEASE <o:p></o:p>
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10作3-043                                                        File No.<o:p></o:p>
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Received from Hainan Airlines Co. Ltd  the sum of ________________ (which is equivalent to us ＄ __________________ ).<o:p></o:p>
In consideration of the receipt of the above named amount, we hereby release and discharge Hainan Airlines Co. Ltd. Its connecting carriers, agents, officers, employee and others in interest, of and from any all claims, demands, actions, or suits at law which we now have or may hereafter have on account of or in connection with shipment under Air Waybill No. ______________, issued on __________________________.<o:p></o:p>
(month)  (day)  (year)<o:p></o:p>
The undersigned herewith agrees to hold Hainan Airlines Co. Ltd free from any and all claims that may be made in the future in reference to or in connection with the said shipment.<o:p></o:p>
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      Date at ______________________ this ___________ day of __________________<o:p></o:p>
          (place)                                (month)<o:p></o:p>
WITNESSED BY:                      CLAIMANT:<o:p></o:p>
________________________________     _________________________________<o:p></o:p>
(Signature)                              (Signature)<o:p></o:p>
  ________________________________     _________________________________<o:p></o:p>
(Name & Address) please print             (Name & Address) please print<o:p></o:p>
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此单一式四联，第一联查询留存，第二联交财务，第三联总部留存，第四联交索赔人。<o:p></o:p>

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赔偿责任解除书(样本)