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[" 附件2："]
[]
["国家中小企业公共服务示范平台"]
["申请报告"]
[]
[" "]
[" "]
[" "]
[" "]
["      申请单位名称：                                    （盖章）"]
["                   "]
["      填报日期：               年          月         日"]
[]
[]
["工 业 和 信 息 化 部 制"]

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["申请报告的主要内容"]
[]
[" 一、国家中小企业公共服务示范平台申请表"]
[" 二、主要服务设备、仪器及软件清单"]
[" 三、主要管理人员和服务人员名单及职称情况一览表"]
[" 四、服务的中小企业名单及服务评价表（100家以上）"]
[" 五、示范平台申请相关情况说明（请另附说明材料）"]
[" （一）申请单位的基本情况（包括：创立发展沿革、发展目标，以及目前的基本情况）；"]
[" （二）服务对象所在区域的行业状况，在区域经济发展中的地位和作用，中小企业发展情况和公共服务需求情况；"]
[" （三）平台管理运营情况（包括：主要管理制度、人员激励、能力提升、可持续发展等）；"]
[" （四）近年来的服务情况（包括：主要服务内容、服务对象、服务规模、方式、收费等，为中小企业提供公益性或低收费服务情况）；"]
[" （五）平台服务特色（包括：在创新服务模式，集聚创新资源等方面的示范性）；"]
[" （六）主要服务业绩及对区域经济和中小企业健康发展的贡献（包括：服务效果自测情况或典型案例）；"]
[" （七）下一步发展设想。"]

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["国家中小企业公共服务示范平台申请表"]
["一、申请单位基本情况"]
["注册日期：",null,null,"单位性质：",null,"法人代表："]
["注册地址：",{"$nulls":5},"邮政编码："]
["联系人：",null,"联系电话：",null,"传真：",null,"手机："]
["网址及备案号（已建网站的填写）：",null,null,null,"电子邮件："]
["注册资本   ____ 万元                                                        ","其中：主要投资方名称",{"$nulls":4},"性质","投资比例 ％"]
[null," ",{"$nulls":5}," "]
[]
[]
[]
[]
[]
["上年末总资产____ 万元","仪器、设备数量    台（套），  购买价格      万元，  占总资产        ％                                                         "]
[{"$nulls":9}," "]
[null,"服务场地面积：      平方米， 其中：自有     平方米， 租用     平方米"]
["从业人数      人",null,"其中：大专及以上学历和中级及以上技术职称的专业人员     人，占总人数   %   "]
["二、运营管理情况（单位：万元）"]
["年度","营业收入    ","其中：      服务收入","资产总额","利润总额",null,"上缴税金","服务中小企业 户数"]
[{"$nulls":4}," ",null," "]
[]
[]
["三、平台服务能力及业绩"]
["获得专业服务资质情况"]
["主要服务内容",null,null,"服务规模（家、人/次）",null,null,"服务收入占年营业收入％"]
{"$rows_empty":8}
["合作资源",null,"签订合作协议的单位",null,null,"其他合作单位"]
{"$rows_empty":9}
["四、政府支持情况"]
["得到政府扶持的情况"]
["省级示范平台认定或国家部委、全国性行业协会的相关认定的文件名称及文号"]

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["主要服务设备、仪器及软件清单"]
["序号","名称","数量","购买时间","购买价格","是否处于行业领先水平"]
{"$rows_empty":23}
[null,null," "]

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["管理人员和服务人员名单及职称情况一览表"]
[]
["姓名","年龄","学历","毕业学校","职称 ","主管工作"]
{"$rows_empty":22}
["备注：不少于20人"]
[null,null,null," "]

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["服务的中小企业名单及服务评价表"]
["序号","服务企业名称","联系人","联系电话","服务内容简述","企业满意度     "]
[{"$nulls":5},"满意","不满意"]
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["上一年度共服务企业        家"]
[null,null,null," "]