需方编号：            签订地点：        签订日期：      年    月    日        合同编号：
______________________________________________________________________________________________________________________
｜  设备  ｜                ｜计量｜      ｜    ｜    ｜要  求｜          ｜合同｜单价：      ｜合  同｜            ｜
｜        ｜                ｜    ｜      ｜数量｜    ｜      ｜          ｜    ｜____________｜      ｜            ｜
｜  名称  ｜                ｜单位｜      ｜    ｜    ｜交货期｜          ｜价格｜总价：      ｜交货期｜            ｜
｜__________________________｜__________________________________________________｜__________________________________｜
｜                          ｜                需        方                      ｜            供    方              ｜
｜  主辅机型号规格：        ｜__________________________________________________｜__________________________________｜
｜                          ｜  订货单位  ｜                                    ｜  供货单位  ｜                    ｜
｜                          ｜____________｜____________________________________｜____________｜____________________｜
｜                          ｜  单项工程  ｜                                    ｜  通讯地址  ｜                    ｜
｜                          ｜____________｜____________________________________｜____________｜____________________｜
｜                          ｜  通讯地址  ｜                                    ｜  邮政编码  ｜    ｜代表人｜      ｜
｜                          ｜____________｜____________________________________｜____________｜____｜______｜______｜
｜                          ｜  邮政编码  ｜            ｜代表人｜              ｜  电    报  ｜    ｜电  话｜      ｜
｜                          ｜____________｜____________｜______｜______________｜____________｜____________________｜
｜                          ｜  电    报  ｜            ｜电  话｜              ｜  结算银行  ｜                    ｜
｜                          ｜            ｜            ｜      ｜              ｜  及帐号    ｜                    ｜
｜__________________________｜____________｜____________________________________｜__________________________________｜
｜                          ｜  结算银行  ｜                                    ｜                                  ｜
｜                          ｜  及帐号    ｜                                    ｜                                  ｜
______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________
｜运输方式  ｜    ｜    ｜供方｜      ｜  到    站  ｜    整车：      零担：    ｜防爆检验合格证号：                ｜
｜__________｜____｜交货｜____｜______｜____________｜__________________________｜验收方法及期限：                  ｜
｜交（提）货｜    ｜方式｜需方｜      ｜  结算方式  ｜                          ｜运杂费用承担：                    ｜
｜地      点｜    ｜    ｜    ｜      ｜            ｜                          ｜包装要求及费用承担：              ｜
｜______________________________________________________________________________｜                                  ｜
｜  违约责任  ｜                                                                ｜                                  ｜
｜______________________________________________________________________________｜__________________________________｜
｜  选择  ｜          ｜记事：          ｜解决合同纠纷的方式：执行本合同发生    ｜鉴（公）证    意见：              ｜
｜        ｜          ｜                ｜争议，由当事人双方协商解决。协商不    ｜                                  ｜
｜  供货  ｜          ｜                ｜成，双方同意由＿＿＿＿仲裁委员会仲    ｜                                  ｜
｜        ｜          ｜                ｜裁（当事人双方不在本合同中约定仲裁    ｜            鉴（公）证机关（章）  ｜
｜  厂家  ｜          ｜                ｜机构，事后又没有达成书面仲裁协议      ｜经办人：          年    月    日  ｜
｜        ｜          ｜                ｜的，可向人民法院起诉）。              ｜                                  ｜
｜__________________________________________________________________________________________________________________｜
｜双方商定的其它事项另附，本合同附件    份                  ｜此合同一式  份，供方  份，需方  份，鉴（公）证机关  份｜
______________________________________________________________________________________________________________________
依照《中华人民共和国经济合同法》和《工矿产品购销合同条例》，经双方协商一致，签订本合同并严格执行。
                                                  监制部门：          印制单位：

颁布 单 位: 国家工商管理局经济合同司
颁布 日 期: 1991