賠償金墊付協(xié)議書范文范本

賠償金墊付協(xié)議書范文范本

甲方（墊付方）：____________________

乙方（接受方）：____________________

鑒于甲方與乙方就___________________（以下簡稱“事件”）達(dá)成一致意見，甲方同意墊付賠償金，乙方同意接受該墊付賠償金，經(jīng)雙方協(xié)商一致，特訂立本賠償金墊付協(xié)議書。

第一條墊付賠償金的金額及支付方式

1.甲方同意墊付賠償金總額為人民幣（大寫）___________________元整（￥___________________）。

2.甲方應(yīng)于本協(xié)議簽訂之日起___________________個(gè)工作日內(nèi)，將上述賠償金支付至乙方指定的銀行賬戶。

3.乙方指定的銀行賬戶信息如下：

開戶行：___________________；

戶名：___________________；

賬號：___________________。

第二條賠償金的用途

乙方接受的賠償金應(yīng)用于___________________事件的賠償，包括但不限于醫(yī)療費(fèi)用、誤工費(fèi)、精神損害撫慰金等。

第三條賠償金的歸還

1.若乙方在___________________事件中獲得第三方賠償，乙方應(yīng)在收到賠償款項(xiàng)后___________________個(gè)工作日內(nèi)，將甲方墊付的賠償金歸還至甲方指定的銀行賬戶。

2.甲方指定的銀行賬戶信息如下：

開戶行：___________________；

戶名：___________________；

賬號：___________________。

第四條違約責(zé)任

1.若甲方未按本協(xié)議約定支付賠償金，應(yīng)向乙方支付違約金，違約金為未支付賠償金總額的___________________%。

2.若乙方未按本協(xié)議約定歸還賠償金，應(yīng)向甲方支付違約金，違約金為未歸還賠償金總額的___________________%。

第五條爭議解決

因本協(xié)議引起的或與本協(xié)議有關(guān)的任何爭議，雙方應(yīng)首先通過友好協(xié)商解決；協(xié)商不成時(shí)，任何一方均可向甲方所在地人民法院提起訴訟。

第六條其他

1.本協(xié)議自雙方簽字蓋章之日起生效。

2.本協(xié)議一式兩份，甲乙雙方各執(zhí)一份，具有同等法律效力。

3.本協(xié)議未盡事宜，雙方可另行協(xié)商解決。

甲方（蓋章）：____________________

授權(quán)代表（簽字）：____________________

日期：____________________

乙方（蓋章）：____________________

授權(quán)代表（簽字）：____________________

日期：____________________

（以下無正文）

附件：雙方身份證復(fù)印件或營業(yè)執(zhí)照復(fù)印件

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