合同编号:_____________
发包方:_____________________________________________
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:_______________________________________________
传真:_________________________________________