擔保信用狀/銀行保證函申請書

APPLICATION FOR STANDBY LETTER OF CREDIT / BANK LETTER OF GUARANTEE

日商瑞穗銀行股份有限公司	臺北分行	臺中分行	高雄分行	國際金融業務分行	日期：

Mizuho Bank, Ltd.	Taipei Branch	Taichung Branch	Kaohsiung Branch	Offshore Banking Unit	Date

申請人茲請貴行以 郵寄／電報 簽發－內容如下之不可撤銷之擔保信用狀／保證函：	編號：

Applicant hereby request you Bank to issue an irrevocable Standby Letter of Credit/Letter of Guarantee, transmit by	No.

airmail/cable as follows：

通知銀行 Advising Bank	申請人開狀人 For account of
地址/Address	地址/Address
受益人 Beneficiary	金額/幣別 Amount/Currency	到期日 Expiry Date
除斥期日 Buffer Period
地址/Address

以為下列之目的（保證函內容浮貼於反面）

for the following purposes (sample of guarantee content attached overleaf)

項目/Items： 履約保證/ Performance Bond 押標金/ Bid Bond 其他/ Others (if any) 關稅保證/ Customs Guarantee ＊如為關稅保證時，授權貴行依關稅局規定之保證書格式簽發。 ＊For Customs Guarantee, the Bank is authorized to issue the Letter of Guarantee with the format designated by the Customs Authority.
開立 不可撤銷之擔保信用狀，或 銀行保證函 遵循ISP 98之擔保函 to open Irrevocable Standby Letter of Credit, or Bank Letter of Guarantee
相關費用之支付 1.保證費用及相關手續費用之支付, 申請人委託 貴行就申請人於 貴行 活存 或 支存 帳號 之存款帳戶轉帳代繳；或 以申請人於扣帳授權書所載帳號之存款扣抵之；或 其他 (請載明其他支付方式)。 2.申請人就保證費用及相關手續費用之支付方式未為勾選時，申請人同意 貴行以申請人於扣帳授權書所載帳號之存款扣抵之。

申請人同意支付 貴行依 貴行規定的保證費用及相關手續費用。
The applicant agrees to pay the Bank the guarantee fee and the relevant handling charges as prescribed by the Bank.

申請人同意償還 貴行所有 貴行依相關信用狀之條款或銀行保證函支付的款項，不論對該受益人之請求權之效力，執行性或其真實性。
The applicant agrees and undertakes to reimburse the Bank for any and all amounts paid by the Bank under or in connection with the Standby Letter of Credit or any Bank Letter of Guarantee. Pursuant to its terms, regardless of the validity, enforceability or genuineness of the claims of the person(s) in whose favour the Standby Letter of Credit or Bank Letter of Guarantee is issued.

申請人同意一經 貴行要求，立即提供現金（或其他貴行滿意之擔保品），其金額由 貴行決定，以涵蓋 貴行於此擔保信用狀或銀行保證函下列所有之義務及責任。
The applicant agrees and undertakes, upon demand by the Bank, to immediately provide cash (or such other collateral satisfactory to the Bank) in an amount determined by the Bank to be sufficient to cover all of the Bank’s obligations and liabilities under and in connection with the Standby Letter of Credit or Bank Letter of Guarantee.

申請人同意如 貴行因申請人之申請而支出任何成本及費用（包括但不限於律師費用）或因相關申請之交易遭受任何直接或間接之損失或損害（包括但不限於與申請人或第三人產生糾紛或爭訟而受有任何損害）時，申請人應對 貴行負賠償責任。
The applicant agrees and undertakes, in the event that any costs or expenses (including but not limited to attorney’s fee) paid or incurred by the Bank or any direct or indirect losses or damages in connection with relevant transactions incurred by the Bank (including but not limited to the damages incurred from the disputes or litigation with the applicant or any third party), the applicant shall compensate the Bank all charges and/or expenses incurred therefrom.

倘申請人係申請 貴行開立擔保信用狀，除其有特別明示外，概依現行有效之信用狀統一慣例，即國際商會出版物之規定辦理。信用狀統一慣例之修改及改定均隨時適用於本申請書。
Except as otherwise expressly provided for in the instruction, if the bank guarantee is in form of a Standby Letter of Credit, it shall be subject to Uniform Customs and Practice for Documentary Credit, International Chamber of Commerce (ICC) Publication currently in force. The Uniform Customers and Practice for Documentary Credits as from time to time revised or amended shall apply.

貴行持有之一切其他文件（包括但不限於付款保證約定書與銀行往來綜合約定書）亦應適用於本項交易。
All other documentation which your bank holds (including but not limited to the Payment Guarantee Agreement and the General Credit Facility Agreement for Banking Transaction) shall also be applicable to this transaction.

【FOR BANK USE ONLY】

主 管	經 辦	核 章	Seal is omitted when sending through Global CMS
申請人簽章 AUTHORIZED SIGNATURE(S) /SEAL(S)