FILE NAME: BR PRODUCER POLICY NO CD SOURCE JUL DT PROC SLIP PAGE
P549131006 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
00 07875 9603117 0 54 141 18 019 001
ITEM REFINS POL NO. SOURCE KIND PERCENT RICO PREMIUM COMPT UPEN FIRST PRF UN CO SECOND PREMIUM CM
1. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
09 00000C-338504 40 00,000 0357 9870 30,000 27,500 9,444.60 1,983.60 0.00
10 00000C-338504 40 00,000 0357 9477 29,000 27,500 9,444.60 1,983.60 0.00
11 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
12 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
13 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
14 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
15 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
16 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
17 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
18 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
19 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
20 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
21 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
22 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
23 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
24 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
25 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
26 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
27 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
28 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
29 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
30 00000C-338504 40 00,000 0357 9614 28,500 27,500 9,444.60 1,983.60 0.00
GRUSS PANE X IU. SECNL PEINS PREMIUM SECOND 154,978.00 143,898.00