VITSE BROKER (Kinito)

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Client Name Client Code ... Occupation Sector Business Address Phone Email State
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Proposal Code Trans Date Start Date End Date Client Name Phone Email Product Class Sum Insured/Assured Gross Premium Payment / Credit
 
 
 
DescriptionAddressSum InsuredBasic FireBasic PremiumS.Peril PremiumFire and S.P. PremiumBurglary PremiumPremium
DescriptionAddressSum InsuredPremium
PrincipalDescriptionSum InsuredPremium
SNTransaction NoCertificate NoInsured nameEmployerInceptionExpiryBank idScopeTenorSum InsuredPremium ratePremiumInsured Account NoInsured Email
DescriptionAddressSum InsuredPremium
DescriptionAddressSum InsuredBasic FireBasic PremiumS.Peril PremiumFire and S.P. PremiumBurglary PremiumPremium
SNInsured / Desc.AddressStart DateEnd DateVariant / OptionSum InsuredPremium RateLTA discount %Package discount %Medical Rate %GPA Ext. %Premium
SNEmployeeDoBAge NBAnnual SalaryAssured RateSum AssuredGrp Life RateGroup Life PremiumFree Cover RateFree Cover PremiumFuneral BenefitFuneral RateFuneral PremiumCritical Ill. RateCritical Ill. PremiumAnnual PremiumPro. DaysProrated Premium
PFI No.PFI DatePFI ValueCurr. RateLoading (C&F) %OriginDestinationSum InsuredPremium Rate %Premium
PFI No.PFI DatePFI ValueCurr. RateLoading (C&F) %OriginDestinationSum InsuredPremium Rate %Premium
ContactVehicle MakeVehicle ModelYear of MakeColourVehicle Plate NumberBody TypeVehicle UseChassis NumberEngine NumberSum InsuredPremium Rate %Premium
DescriptionAddressSum InsuredPremium
 
 
 
 
Policy Code Proposal Code Trans Date Start Date End Date Insurer(s) Client Name Phone Email Product Class Sum Insured/Assured Gross Premium Payment / Credit
Claim Code Policy Code Debit Code Trans Date Notify Date Loss Date Report Date Description Insurer(s) Client Name Phone Email Product Class Loss Amount Paid Amount
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