BORDEREAUX SUMMARY REPORT BY DATE - 15 July 2013

Accensure Insurance Brokers - Cape Town
P O Box 12061
N1 City, Goodwood
7463
021 5920122
021 5920138
4380101289

Postal Address

Tel No.
Fax No.
VAT No.

First National Bank
Corporate
255005
62192888281
Current

INSURANCE COMPANY - Etana Insurance Co Ltd
PRODUCT NAME
- Flexiplus

VAT No - 4840209946

POLICY DETAILS

PREMIUM

Policy Number

Client Name

PRODUCT NAME

Premium

23 994.12
POLICY
COUNT -

15

CLIENT COUNT - 15

23,994.12

Client Name

ETANA/CAR-Z/9023/M100002 - 2012b - 2013a
POLICY
COUNT -

VAT

PRIMA TOOL HIRE CC
1

CLIENT COUNT - 1

Premium

Comm

TOTAL
Nett

Premium

Comm

3 940.97
3,940.97

20 053.15
20,053.15

723.39
723.39

72.34
72.34

651.05
651.05

20 704.20
20,704.20

TOTAL

81.86
214.48
160.57
123.63
862.21
229.47
184.93
100.71
985.40
144.47
122.77
110.68
386.49
130.26
175.38

667.98
1 552.50
1 014.55
845.18
5 972.60
1 419.59
1 323.68
660.21
6 596.44
1 199.64
870.72
772.53
2 523.95
904.34
1 118.45

4 013.31
4,013.31

27 442.35
27,442.35

Comm

SASRIA
Nett

Sasria

Comm

TOTAL
Nett

Premium

Comm

TOTAL

416.67

83.33

333.33

0.00

0.00

0.00

333.33

83.33

458.33

416.67

83.33
83.33

333.33
333.33

0.00
0.00

0.00
0.00

0.00
0.00

333.33
333.33

83.33
83.33

458.33
458.33

416.67

- ETANA MULTIMARK III (Arrears)

POLICY DETAILS
Policy Number

PREMIUM
Client Name

ETANA/MM-Z/AR/9022/M00030
ETANA/MM-Z/AR/9022/M00007
ETANA/MM-Z/AR/9022/M00004
ETANA/MM-Z/AR/9022/M00002
ETANA/MM-Z/AR/9022/M00033
ETANA/MM-Z/AR/9022/M00005
ETANA/MM-Z/AR/9023/M00010. - 2013a
ETANA/MM-Z/AR/9022/M00035
ETANA/MM-Z/AR/9023/M00001

Date Printed

Sasria

PREMIUM

Policy Number

PRODUCT NAME

SASRIA
Nett

- C.A.R.

POLICY DETAILS

TOTAL
TOTAL PER PRODUCT

Comm

580.43
80.91
499.53
9.50
0.95
8.55
508.08
Calvert - MR E R
212.13
1 141.46
23.56
2.36
21.20
1 162.66
CARRIBBEAN POOLS AND MR L MERCUUR & MISS K SAWYER 1 353.58
879.21
159.07
720.14
15.00
1.50
13.50
733.64
COETZEE MR M & MRS C AND COLLEENS HAIR SALON
710.16
122.23
587.92
14.01
1.40
12.61
600.53
DAVE MILL ROOFING CC AND MR D APRIL
4 997.72
818.70
4 179.02
43.51- EDWARDS
391.60STATIONERY
4 570.62
EDWARDS OFFICE NATIONAL & MAYS STATIONERS CC & EDWARDS
STATIONERY CANAL
WALK T/AS EDWARDS
OFFICE435.11
NATIONAL (T/As)
(PTY) LTD
1 317.78
227.88
1 089.90
15.92
1.59
14.33
1 104.23
HERMANS S AND MISS N AND FAMILY FTRR&I
1 139.13
181.87
957.26
30.65
3.06
27.58
984.84
IMVUSA TRADING 1378 CC (T/As) - LAUBSCHER; A
555.90
99.84
456.06
8.72
0.87
7.84
463.91
ISMAIL S MR & ISMAIL Y MR & ISMAIL AK
5 998.85
980.55
5 018.30
48.49
4.85
43.64
5 061.94
JWEC CONTRACTING (PTY) LTD AND MR J I C AND MRS S H WILLIAMS
1 041.49
143.07
898.42
14.00
1.40
12.60
911.02
NASCIMENTO A DO MR
750.79
120.78
630.01
19.86
1.99
17.88
647.89
NUTON TRADING CC
659.57
109.98
549.60
7.00
0.70
6.30
555.90
Parker A - Mr
2 264.78
380.69
1 884.09
57.98
5.80
52.18
1 936.27
PICBEL TAKE AWAYS; MRS D EBRAHIM; A EBRAHIM & MR M EBRAHIM
FTRRI
128.90
644.50
13.60
1.36
12.24
656.74
SIZWE PRESS & MR A & MISS P E MANUEL (T/As) - READY PRESS 773.39
971.32
174.38
796.93
10.00
1.00
9.00
805.93
WILLIAM PETERSON AND ASSOCIATES AND MR W AND MRS MD PETERSON

ETANA/FLEX-Z/9022/M00007
ETANA/FLEX-Z/9022/M00018 - 2013a
ETANA/FLEX-Z/9022/M00001
ETANA/FLEX-Z/9022/M00019
ETANA/FLEX-Z/9022/M00008
ETANA/FLEX-Z/9022/M00009
ETANA/FLEX-Z/9022/M00003
ETANA/FLEX-Z/9022/M00012
ETANA/FLEX-Z/9022/M00014
ETANA/FLEX-Z/9022/M00005
ETANA/FLEX-Z/9022/M00017
ETANA/FLEX-Z/9022/M00016
ETANA/FLEX-Z/9022/M00011
ETANA/FLEX-Z/9022/M00015
ETANA/FLEX-Z/9022/M00013
TOTAL
TOTAL PER PRODUCT

VAT

09 July 2013

VAT

Premium

4 KOEBERG ROAD INVESTMENTS CC
ABDURAHMAN - MRS A
ALL-PRO FOODS (T/As) - ALL-PRO DISTRIBUTORS CC
BELLVILLE GLASS (T/As) - ASHRAFS WINDSCREENS CC
BRAND ID AFRICA & CHKBIZ (PTY) LTD
BUILDING SUPER STRUCTURES CC
CAPE SHIPPING SUPPLIES CC
COLORADO TV REPAIRERS AND HIRE (T/As) - M SALIE
DR G GALVAAN

1 152.54
548.16
613.40
8 940.79
1 700.87
697.55
1 081.71
657.67
575.79

Comm
230.51
109.63
88.90
1 306.63
340.17
139.51
185.41
131.53
115.16

SASRIA
Nett
922.03
438.53
524.50
7 634.16
1 360.70
558.04
896.31
526.14
460.64

Page 1 of 3

Sasria
174.90
41.64
14.00
315.22
40.54
102.60
58.06
15.94
5.89

Comm
17.49
4.16
1.40
31.52
4.05
10.26
5.81
1.59
0.59

TOTAL
Nett
157.41
37.47
12.60
283.69
36.49
92.34
52.25
14.35
5.31

Premium
1 079.43
476.00
537.10
7 917.86
1 397.18
650.39
948.56
540.49
465.94

Comm

TOTAL

248.00
113.80
90.30
1 338.15
344.23
149.77
191.21
133.13
115.75

1 482.68
644.61
647.40
10 220.08
1 951.50
909.91
1 467.94
789.38
759.27

Printed By - Cims

952.90 22.00 0.451.91 524.67 20.Cims .60 1 609.589.53 PUBLIC AND ALLIED WORKERS UNION OF SOUTH AFRICA REHOBOTH AGE EXCHANGE & CAPE TOWN CITY MISSION (FTRRI)2 302.21 296.16 4 102.33 67 952.42 3.08 .74 5 553.13 67.01 311.22 73.60 202.68 51.32 65.26 13 262.78 18.01 74.00 773.33 193.69 17.10 966.28 204.05 1 855.35 381.62 200. HAVEN-SHELTER .81 207.21 19.81 96.70 G H STARCK CENTRE & CAPE CITY MISSION (FTRRI) 2 469.05 1 175.04 100.68 579.76 435.521.93 94.50 1.34 PRINCETON`S MENS BOUTIQUE (POSH CLOTHING CC T/AS) 3 688.353.26 416.92 839.98 1 260.62 435.47 13.08 1 400.81 207.70 1 344.16 2.33 193.99 2 950.18 6 MALAN STREET BODY CORPORATE POLICY COUNT POLICY - 1 54 CLIENT COUNT .53 VAT Premium Comm SASRIA Nett Sasria Comm TOTAL Nett Premium Comm TOTAL 1 024.13 4 353.1 CLIENT COUNT .05 396.52 416.19 1 199.46 Client Name ETANA/ENG-Z/9022/M00005 VAT HERCULES BUILDERS POLICY COUNT - 1 CLIENT COUNT .74 96.33 1 113.60 694.18 14.00 PREMIUM Policy Number PRODUCT NAME 957.87 552.97 204.11 809.76 105.83 17.00 0.02 976.13 22.60 4.37 415.20 172.60 55.71 17 868.78 75.97 819.96 8.64 168.91 15.07 SOOTHE BODY AND SKINCARE STUDIO 1 468.33 773.47 27.22 6 928.91 4.00 0.44 1 256.67 2 826.00 17.40 0.11 9.23 372.33 1 176.81 839.90 8.17 87.85 23.870.10 90.36 633.24 71 870.23 1 111.84 HYPERCUT (T/As) .79 3 084.10 153.85 0.941.1 Premium 1 008.56 5.32 258.20 270.62 FRAME IT (T/As) .43 75.32 109.06 WOODWORK SPECIALISTS WYNBERG GLASS (T/As) .46 139.05 19.27 SECURI-TECH SA (PTY) LTD & SECURI-PACK (PTY) LTD 835.33 773.31 JOSDEL PROPERTIES NO 85 (PTY) LTD 2 272.10 4 193.01 293.00 19.67 632.45 4 182.11 207.26 1.WHITE COTTON 2 533.70 6.30 10.73 16.76 1.50 19.95 8.55 153.33 193.90 819.78 1 384.36 82.73 46.87 204.43 VOS (DR P J) WDCD ENGINEERING SUPPLIES (FORREST ENGINEERING T/AS) 1 381.58 5 910.18 KLOOF STREET MOTORS (PTY) LTD (DCA18 SERVICE STATION T/AS) 6 809.98 SILVERLEA PRIMARY SCHOOL 465.14 198.99 2 156.L.00 107.94 89.2013a ETANA/MM-Z/AR/9023/M00006 ETANA/MM-Z/AR/9022/M00042 ETANA/MM-Z/AR/9022/M00016 ETANA/MM-Z/AR/9022/M00014 ETANA/MM-Z/AR/9022/M00020 ETANA/MM-Z/AR/9024/M00001 .17 1 733.97 74.199.33 14.49 1.75 2 824.35 154.62 397.30 O.00 773.50 1 537.931.50 4.92 19.07 168.55 2 028.97 17.92 304.59 405.44 171.JENNY M LEISURE FOODS CC 355.81 LABEL TECHNIQUES (T/As) .35 5 386.33 773.30 2 065.84 0.71 11.21 19.70 7.81 624.87 204.36 3.BORDEREAUX SUMMARY REPORT BY DATE .00 0.85 167.46 684.13 2 711.87 410.44 7 770.33 966.SOUTH PENINSULA GLASS CENTRE CC4 741.113.75 3 520.2013a ETANA/MM-Z/AR/9022/M00001 ETANA/MM-Z/AR/9022/M00045 ETANA/MM-Z/AR/9023/M00002 ETANA/MM-Z/AR/9023/M00008 ETANA/MM-Z/AR/9022/M00047 ETANA/MM-Z/AR/9022/M00023 . ETANA/MM-Z/AR/9021/M00001 ETANA/MM-Z/AR/9022/M00040 .69 14.00 192.954.79 372.27 1 831.90 97.94 10.471.24 435.02 2 587.664.14 EVANGELIC BIBLE CHURCH 375.78 7 723.83 1 158.35 847.84 2 930.20 0.95 PRIMA TOOL HIRE CC 3 206.12 395.21 94.39 341.07 81.53 1 207.96 1 358.05 47.MR D AND MRS CB CRISTALLIDES 614.68 117.60 14.65 COUNT - Date Printed 09 July 2013 Page 2 of 3 Printed By .61 284.13 3 000.46 POLICY COUNT - 36 CLIENT COUNT .024.05 1 333.19 1 199.27 830.48 249.64 0.58 88.93 2 727.64 1 296.61 158.37 14 954.80 0.52 2 003.08 1 140.55 SATELITE TV AND AERIAL INSTALLTION (T/As) .49 1 024.33 1.FEBRUARY J 136.05 1.25 ETANA/MM-Z/AR/9022/M00012 ETANA/MM-Z/AR/9023/M00005.14 96.37 71.56 1.00 9.07 27.49 108.MTL LABELS AND FINSHING (PTY) LTD 1 046.67 193.43 540.JSR ROSS 14 809.40 288.81 743.71 ESTRALLITA MARINE CC 1 012.36 21.60 2 625.87 1 676.50 4.35 737.71 364.451.79 J M F RETICULATION (T/As) .33 0.33 193.ENGINEERING/CONTRACTORS POLICY DETAILS TOTAL TOTAL PER PRODUCT 200.87 1.55 4.69 96 451.00 648.85 126.93 618.72 113.14 Nett Sasria Comm SASRIA Comm TOTAL Nett Premium Comm TOTAL 193.00 0.39 2 381.00 0.10 1 600.40 403.74 204.60 7.43 183.29 10.73 15.90 22.50 0.67 .71 11 878.49 2 138.67 POLICY DETAILS TOTAL TOTAL PER PRODUCT 56.84 5.92 839.00 0.33 773.13 2.41 668.09 929.98 545.28 14 519.91 480.90 71.47 198.87 2 185.97 819.87 THUNDERSTRUCK INVESTMENTS 81 (PTY) LTD 1 941.90 280.74 9.84 39.13 2.CJ VISSER 1 542.06 2 564.77 341.60 435.33 0.18 206.38 90.36 3 918.20 93.BODY CORPORATE / SECTIONAL TITLE PREMIUM Policy Number Client Name ETANA/BC/AR/9022/M00001 TOTAL PER INSURER 5.14 5.83 HOPE OF AFRICA CHRISTIAN COLLEGE (T/As) .89 3 737.51 GIGGLING GOURMET (T/As) .90 638.W.01 2 171.95 9.00 176.16 9.33 1 113.89 URBAN SOUL COMMUNICATIONS (PTY) LTD 484.12 509.52 49.099.67 527.14 5 787.00 5.519.33 966.71 300.873.15 July 2013 1 157.19 207.73 841.64 356.LANSDOWNE 2 905.918.2013a ETANA/MM-Z/AR/9022/M00024 ETANA/MM-Z/AR/9022/M00050 ETANA/MM-Z/AR/9022/M00051 ETANA/MM-Z/AR/9022/M00052 ETANA/MM-Z/AR/9022/M00026 ETANA/MM-Z/AR/9022/M00053 ETANA/MM-Z/AR/9022/M00028 ETANA/MM-Z/AR/9022/M00054 ETANA/MM-Z/AR/9021/M00002 ETANA/MM-Z/AR/9022/M00029 ETANA/MM-Z/AR/9022/M00055 TOTAL TOTAL PER PRODUCT PRODUCT NAME 82 471.21 2.66 71.83 5 941.62 ZINTATHU-M CONSTRUCTION (SPELLBOUND TRADING 119 T/AS) 720.82 1 937.

Cims .12 509.099.589.65 Printed By .931.05 19.BORDEREAUX SUMMARY REPORT BY DATE .15 July 2013 TOTAL PER REPORT Date Printed POLICY COUNT - 09 July 2013 54 CLIENT COUNT - 53 108.451.84 Page 3 of 3 5.21 94.664.94 89.91 4.941.85 126.873.78 18.521.