American Life Insurance Company

MetLife Building, 18-20 Motijheel C. A.

P.O. Box 9, Dhaka – 1000
Bangladesh
20-Oct-20
T (880-2) 9561791
F (880-2) 9558682
Group Insurance Renewal Premium Bill

Name of Policyholder Infolady Social Enterprise Limited

Policy Number BGL- 60636
Anniversary 23-Oct-21

Life 2.55
AD
Premium Per Thousand Per Year APTD 1.20
APPD
Total 3.75

Premium Per member Per Year IP (45k R&B 1k) BDT 2,052

AD, APTD,
Cert ID Insured GL
Sl. Name of Insured DoB Age IP APPD IP Prem. Total (BDT) Remarks
No. Amount Premium
Premium
1 1 Dr. Ananya Raihan 24-11-66 55 1,500,000 45K 3,825 1,800 2,052 7,677 EOI: Medical, Urine,ECG
2 77 Priashis Basak 11-01-84 38 1,080,000 45K 2,754 1,296 2,052 6,102
3 16 Imon Chandra Banik 17-08-91 30 480,000 45K 1,224 576 2,052 3,852
4 29 Rabin Istek Naeem 30-11-96 25 360,000 45K 918 432 2,052 3,402
5 17 Sk. Masudur Rahman 25-12-80 41 1,440,000 45K 3,672 1,728 2,052 7,452
6 25 Naimul Haque Joarder 24-07-73 48 480,000 45K 1,224 576 2,052 3,852
7 33 Md. Mahmudul Hasan Rocky 01-06-94 27 324,000 45K 826 389 2,052 3,267
8 90 Sayeda Maksuda Jahan 17-12-90 31 420,000 45K 1,071 504 2,052 3,627
9 96 Sha Al Araf 10-05-93 28 180,000 45K 459 216 2,052 2,727
10 110 Fariha Ahmed 23-01-94 28 420,000 45K 1,071 504 2,052 3,627
11 122 Tasnim Mustaque 29-10-94 27 900,000 45K 2,295 1,080 2,052 5,427
12 133 Saleha Khanam 10-11-96 25 120,000 45K 306 144 2,052 2,502
13 118 Md. Sazzadur Rahman (Sazib) 01-01-89 33 540,000 45K 1,377 648 2,052 4,077
14 36 Israfil Hossein 22-10-91 30 420,000 45K 1,071 504 2,052 3,627
15 95 Md. Ariful Islam 20-10-92 29 192,000 No IP 490 230 - 720
16 Not Given Sabbir Ahmed Hemo 11-09-96 25 420,000 45K 1,071 504 2,052 3,627
17 Not Given Rio Chakma 06-12-93 28 420,000 45K 1,071 504 2,052 3,627
18 Not Given Rajib Kumar Roy 30-11-89 32 162,000 No IP 413 194 - 608
19 Not Given Md. Alamin Hossain 10-12-89 32 216,000 No IP 551 259 - 810
20 Not Given Falguni Biswas 03-02-89 33 480,000 45K 1,224 576 2,052 3,852
21 Not Given Minhaz Uddin Razu 29-10-95 26 204,000 45K 520 245 2,052 2,817
22 Not Given Anupama Islam Nisho 01-02-89 33 540,000 45K 1,377 648 2,052 4,077
23 Not Given Tarmeem Tarannum Mollik 18-05-95 26 264,000 45K 673 317 2,052 3,042
24 New JoinerMd. Munzurul Hasan 07-05-92 29 840,000 45K 2,142 1,008 2,052 5,202
25 New JoinerMd. Raihan Haque 10-11-92 29 720,000 45K 1,836 864 2,052 4,752
26 New JoinerKh. Shahnizam 13-11-85 36 459,000 45K 1,170 551 2,052 3,773
27 New JoinerMd. Mahabubur Rahman (Nafi) 15-12-95 26 420,000 45K 1,071 504 2,052 3,627
28 New JoinerMd. Golam Mahmood 02-06-94 27 168,000 45K 428 202 2,052 2,682
29 New JoinerAqibul Islam 25-02-97 25 168,000 45K 428 202 2,052 2,682
30 New JoinerSadiatul Fatema 23-06-94 27 180,000 45K 459 216 2,052 2,727
31 New JoinerTelova Rohane Tropa 08-12-86 35 144,000 45K 367 173 2,052 2,592
32 New JoinerMd. Amir Hossain 10-01-90 32 156,000 No IP 398 187 - 585
33 New JoinerSah Alom 22-08-91 30 144,000 No IP 367 173 - 540
34 New JoinerNazmul Haque 15-07-87 34 156,000 No IP 398 187 - 585

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 AD, APTD,
Cert ID Insured GL
Sl. Name of Insured DoB Age IP APPD IP Prem. Total (BDT) Remarks
No. Amount Premium
Premium
35 New JoinerSumon Islam 06-09-94 27 144,000 No IP 367 173 - 540
36 New JoinerAzim Uddin 25-12-89 32 156,000 No IP 398 187 - 585
Total 15,417,000 39,313 18,500 57,456 115,270
Net Renewal Premium 115,270

(Taka One Hundred Fifteen Thousand Two Hundred & Seventy Only)

Mohammad Shafiqul Alam

Manager
Employee Benefits

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