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SUCURSALA IASI BORDEROU ASIGURARI GENERALE

NR :116 Judet Iasi Nr. Tip Crt. 1S 2S 3S 4S 5S 6S 7S 8 9 10 11 Data08.08.2011 Valuta/ Ron Data Suma Obs incasarii 08/05/11 31.5 08/05/11 31.5 08/07/11 19.00 08/07/11 19.00 08/07/11 19.00 08/07/11 28.70 08/05/11 20.6 AGENT OLARIU MIRELA3228 An Numar Polita Asigurat emitere 2011 MP951396 GAVRILESCU DAN 2011 MP951395 GAVRILESCU MARIA 2011 MP951400 DALAS ECATERINA 2011 MP951397 DALAS MADALINA 2011 MP951399 DALAS VIOLETA 2011 MP007031337 BUZILA OCTAVIAN 2011 MP007030679 ZMAU MARIA

Nr si tip document CH5689887 CH5689887 CH5689888 CH5689888 CH5689888 CH8758648 CH8754548

TOTAL
Tip polita 1 2 3 4 5 6 7 8 Incendiu 9 Transport valori 10 CASCO K Cargo V Accidente auto G Auto conventie S Furt Tilharie MPX Aviatie 11 Maritim Accidente angajati Buket(Omnitrans) Carte Verde Garant Medicale Malpraxis Casco Post -Daewoo Daewoo Cash Tip document: OP ordin plata CH chitanta

169.3

AGENT OLARIU MIRELA 3228
(semnatura si stampila )

Verificat Omniasig VIG
( semnatura si stampila )

SUCURSALA IASI BORDEROU ASIGURARI GENERALE
NR :116 Judet Iasi Nr. Tip Crt. 1S 2S 3S 4S 5S 6S 7S 8 9 10 11
Tip document:: OP ordin plata CH chitanta

Data08.08.2011 Valuta/ Ron Data Suma Obs incasarii 08/05/11 31.5 08/05/11 31.5 08/07/11 19.00 08/07/11 19.00 08/07/11 19.00 08/07/11 28.70 08/05/11 20.6

AGENT OLARIU MIRELA3228 An Numar Polita Asigurat emitere 2011 MP951396 GAVRILESCU DAN 2011 MP951395 GAVRILESCU MARIA 2011 MP951400 DALAS ECATERINA 2011 MP951397 DALAS MADALINA 2011 MP951399 DALAS VIOLETA 2011 MP007031337 BUZILA OCTAVIAN 2011 MP007030679 ZMAU MARIA

Nr si tip document CH5689887 CH5689887 CH5689888 CH5689888 CH5689888 CH8758648 CH8754548

TOTAL 169.3 AGENT OLARIU MIRELA3228
(semnatura )

Tip polita Incendiu 9 1 Transport valori 10 2 3 4 5 6 CASCO K Cargo V Accidente auto G Auto conventie S Furt Tilharie MPX

Maritim Accidente angajati Buket(Omnitrans) Carte Verde Garant Medicale Malpraxis

Verificat Omniasig VIG
(semnatura )

7 196 Aviatie 11 0 Casco Post -Daewoo Daewoo Cash 28214 0 0 0 05/26/62 169.3 0 .