Statement of Account for the period from 01/09/2021 to 30/09/2021

Executive : ANJALI
Name : GULAM NABI GENRAL TRADING LLC Date : 02/10/2021
Page : Page 1 of 1
P.O. BOX 172071, DUBAI, U.A.E. Account : 1-1-1-11-1410-14851
Currency : UAE DIRHAMS

Voucher Date / No Policy DB / CR Description Debit Credit Balance

No. Note No.

Opening Balance - September 2021 0.00 DB

14/09/2021 895122 1791 895122 116367 VAT @ 5% on Policy No. 1791 84.97 0.00

14/09/2021 895123 DUBAI HEALTH AUTHORITY CHARGES ON 77.70 0.00

POLICY NO: 601001791 / 1
PREMIUM: AED. 77.70/

14/09/2021 0 1791 895122 116367 MEDICAL INSURANCE 1,699.46 0.00

Transaction(s) Total - September 2021 1,862.00 0.00

Closing Balance - September 2021 1,862.00 DB

0 - 30 Days 31 - 60 Days 61 - 90 Days 91 - 120 Days >= 121 Days

1,862.13 0.45 0.00 0.00 0.00

*** Individual Account: The credit period for payment of premium is nil. Premium is payable in advance of policy issuance.
*** Company Account: The credit period for payment of premium is thirty (30) or sixty (60) days from date of policy issuance.
*** Please note the Credit Facility on your account will be frozen automatically if any premium is overdue beyond your
credit period of thirty (30) or sixty (60) days at the close of the month.
*** All other services under your policy/s and account/s will continue and be provided to the best of our abilities.
*** Payment made after 30/09/2021 will be reflected in the next month's statement.
Post Dated Cheques 'IF ANY' will be credited on due date(s) and will reflect only in the statement of month of credit.
If no query is received within 7 days from the date of statement it will be presumed that it is accepted and correct.
Method of Premium Payment:
- Cash
- Cheque payable to "The Oriental Insurance Co Ltd."
- Credit Card
- Wire Transfer:
• ACCOUNT NAME – THE ORIENTAL INSURANCE CO LTD.(ACCOUNT NO. 2)
• ACCOUNT NO. – 90010200018376
• SWIFT CODE NO: BARBAEADDUB.
• IBAN NO. - AE520110090010200018376
• BANK NAME – BANK OF BARODA, BUR DUBAI