MAYFAIR INSURANCE COMPANY LIMITED

MAYFAIR CENTRE 8TH FLOOR, RALPH BUNCHE ROAD

P.O.BOX 45161- G.P.O. (00100), NAIROBI, KENYA
TEL: 2999000, FAX 2999111,
Email: info@mayfair.co.ke

Endorsement Advice Client Code: KE-0728 Client Pin: A001207909Z

On Account B-CR01 - CROWNSCOPE INSURANCE BROKERS Premium KSH.

LIMITED
Extra Premium
The Insured KENNEDY K.BUSISA
Premium 0.00
Address P.O BOX 12789-00100 NAIROBI Political 0.00

05/0700/23094/2022 Excess Protector 0.00

Endorsement/Renewal No.
P.H.C Fund 0.00
Policy No. 01/COMP/01/0700/38242/2022
Stamp Duty 0.00
Period of Insurance From: 01/07/2022 } Both Dates Training Levy 0.00
To: 30/06/2023 } Inclusive Total 0.00
Cover Type. Motor Private - Comprehensive

PARTICULARS OF THE VEHICLE

Reg Make Body Horse Year Carrying Insured Wind Radio

Mark Type Power of Capacity Estimate Screen Casset
/CC Manuf Value KSH Limit Limit
KBN 494C Toyota Station Wagon 2990 2003 780,000 50,000.00 50,000.00
Totals 780,000.00

It is further understood and agreed that the Limits have been amended to read as below:

Windscreen limit Kshs 50,000/=

Radio cassette limit Kshs 50,000/=
(All Other Terms & Conditions Remain Unaltered)

Signed for and on behalf of Mayfair Insurance Company Limited

/NN Issued at Nairobi On 28/12/2022 Signature..................................