Agent Bill July 2011 60

Dev Officer Wise Agent Bill
Time run: 8/1/2011 11:46:23 AM

Dev Officer Code - Dev Officer Name
Office Code :
Party License Number
Party License Expiry Date
Site Code
Agent Type
Agent Code
Agent Name
230400
932678
8/12/2011
1D3937822
Agent
1D3935979
AFROZE PATALWALA
Party Address
Department
162, AASHIYANA, SARJAN

SOCIETY ATHWALINES
SURAT
Policy Number
Endorsment Number
11 Fire
Client Type
Effective Start Date
Policy Expiry Date
23040011110100000825:
Insured Name
Individual
28/07/2011
27/07/2012
23040011110100000826:
Individual
28/07/2011
27/07/2012
23040011110100001002:
Individual
30/07/2011
29/07/2012
23040031110100013031:
Mr. MR, VIRAF RATAN MESSMAN .
Individual
7/7/2011
6/7/2012
23040031110100012840:
FIROZBAHI E. DUMASIA.
Individual
8/7/2011
7/7/2012
23040031110100012880:
Mr. MR, DEVANG D KHADEPAV .
Individual
19/07/2011
18/07/2012
23040031110100013036:
Mr. MR, DEVANG D KHADEPAV .
Individual
19/07/2011
18/07/2012
23040031110200013638:
Mr. PUSHKAR H DALAL
Individual
20/07/2011
19/07/2012
23040031110200014964:
Mr. MR, ZARIR S KATPITIA .
Individual
21/07/2011
20/07/2012
23040031110100014339:
HEMANT.S. MARFATIA
Individual
23/07/2011
22/07/2012
23040031110100014638:
HEMANT.S. MARFATIA
Individual
23/07/2011
22/07/2012
23040031110200014961:
Mr. MR, ZARIR S KATPITIA .
Individual
26/07/2011
25/07/2012
23040031110200013815:
Mr. AMEE SATYENBHAI DALAL
Individual
28/07/2011
27/07/2012
23040031110100013400:
PUSHKAR H. DALAL
Individual
30/07/2011
29/07/2012
23040031110100016256:
Mr. MR, PRADEEP RATILAL NAVIK .
Individual
3/8/2011
2/8/2012
23040034110100002878:
PILU H RABADI
Individual
29/06/2011
28/06/2012
23040034110100003159:
SUNIL SURESH DHAMANWALA
Individual
2/7/2011
1/7/2012
23040034110100003162:
SATISHKUMAR C MODI
Individual
2/7/2011
1/7/2012
23040034110100003239:
KHUSHRU R KAMAKHAN
Individual
5/7/2011
4/7/2012
23040034110100003950:
KAUSHIK S. DALAL
Individual
25/07/2011
24/07/2012
23040034110100003905:
SHANTILAL L DALAL
Individual
26/07/2011
25/07/2012
11 Fire Total
31 Motor
31 Motor Total
34 Health Insurance
34 Health Insurance Total
Premium Amount
Commission
420
28
300
20
680
1400
68
116
748
30
598
22
1063
61
380
1005
0
463
3125
1115
7575
607
504
16576
12
740
702
10431
1565
18252
2738
3990
599
14210
2132
17037
63920
852
8588
46 Traditional Business - Miscellaneous
23040046110100000075:
Mr. MRS.KETY C TODIWALA
Individual
30/07/2011
29/07/2012
23040048110500000082:
Mr. ADIL M. BARIA .
Individual
4/7/2011
3/7/2012
23040042110100001432:
SATISHKUMAR C MODI
Individual
2/7/2011
1/7/2012
23040042110100001434:
MANISH N GANDHI
Individual
5/7/2011
4/7/2012
23040036110400000018:
Mr. DR. HOMI DARABSHAH DOODHWALA
Individual
19/07/2011
18/07/2012
23040036110400000019:
DR. (MRS) PERSIS HOMI MEWAWALA
Individual
19/07/2011
18/07/2012
23040042110100001725:
KAUSHIK S DALAL
Individual
20/07/2011
19/07/2012
23040042110100001762:
KAUSHIK S DALAL
Individual
20/07/2011
19/07/2012
23040042110100001765:
PARMAR MUKESH NATVARBHAI
Individual
28/07/2011
27/07/2012
Client Type
960
960
144
144
4596
4596
660
660
1620
243
392
59
1600
240
800
120
1422
213
203
6037
93489
30
905
11153
46 Traditional Business - Miscellaneous Total

48 Misc - Non Traditional Business
48 Misc - Non Traditional Business Total
Grand Total
Site Code
Agent Type
Agent Code
52650
19/06/2010
1D3938055
Agent
1D3936212
Agent Name
SURESHCHANDRA K
SANKHLA
Party Address
Department
3, MEGHMALHAR, NR.
VIDYA BHARTI SCHOOL,
BHATAR CHAR RASTA
SURAT
Policy Number
Endorsment Number
Insured Name
Policy Expiry Date
23040031110100011990:
Mr. NILESHKUMAR SURESHCHANDRA SANKHLA . Individual
1/7/2011
30/06/2012
23040031110100012837:
Mr. SURESHCHANDRA KHAYALILAL SANKHLA
Individual
9/7/2011
8/7/2012
Premium Amount
780
33
4250
5030
5030
314
347
347
31 Motor
31 Motor Total
Grand Total
Site Code
Agent Type
Agent Code
625696
28/08/2014
1D4024258
Agent
1D4019280
Agent Name
HARIVADAN J
HAVELIWALA
Party Address
Department
301 ORION HOUSE B/H RESHAM BHAWAN LAL

DARWAJA
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110600000526:
Mr. ASHWIN TARACHAND ADANI -
Individual
11/7/2011
4/7/2012
23040034110100003745:
PAWAR PRAKASH SHANTARAM.
Individual
15/07/2011
14/07/2012
23040034110600000616:
RAJKISHORDAS RAJKISHORDAS
Individual
17/07/2011
16/07/2012
23040034110600000617:
CHINTAMANIJI PRANAMI
Individual
17/07/2011
16/07/2012
34 Health Insurance
Commission
Premium Amount
Commission
0
6674
1001
1550
233
1800
270
23040034110100003999:
NIRAV S GOLWALA
Individual
21/07/2011
20/07/2012
23040042110100001574:
Mr. PARMAR MEHUL DINESHBHAI -
Individual
8/7/2011
7/7/2012
23040042110100001580:
PARMAR DINESHBHAI NATVARBHAI
Individual
10/7/2011
9/7/2012
Grand Total
Site Code
Agent Type
Agent Code
1223674
7/9/2011
1D4024260
Agent
1D4019282
Agent Name
RAJENDRA M GHEEWALA
Party Address
Department
18, PATEL NAGAR

SOCIETY NO : 1, NR.
DARGAH, ADAJAN
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
31 Motor
23040031110100015964:
DIPAKBHAI M. PATEL
Individual
31/07/2011
30/07/2012
31 Motor Total
Grand Total
Site Code
Agent Type
Agent Code
1285066
9/7/2012
1D4024342
Agent
1D4019364
Agent Name
KAMLESH
ANIRUDDHABHAI
BHAHMBHATT
Party Address
Department
B - 3, NEVIL CHAMBERS,
SUNLIGHT COMPLEX, B/H
- BHULKA BHAWAN,
ANAND MAHAL ROAD
ADAJAN
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100004094:
GOYAL VINOD SHYAMAL.
Individual
27/07/2011
26/07/2012
23040034110100003894:
DR. KANUGA MAKSUD G.
Individual
29/07/2011
28/07/2012
34 Health Insurance
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
1846583
1/12/2013
1D4024372
Agent
1D4019394
BEENA RAJESH SHAH
Party Address
Department
H - 1, 1/528, RAVI PARK

APPT. NR. DALICHAND
NAGAR ATHWAGATE
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110600000619:
VISHAL MAFATLAL SHAH.
Individual
17/07/2011
16/07/2012
23040034110600000618:
MR. MAFATLAL P. SHAH.
Individual
19/07/2011
18/07/2012
34 Health Insurance
Grand Total
489926
3375
13399
506
2010
240
36
203
443
13842
30
66
2076
Premium Amount
Commission
5680
5680
5680
Premium Amount
442
442
442
Commission
8671
1301
24660
33331
33331
3699
5000
5000
Premium Amount
Commission
700
105
3465
4165
4165
520
625
625

Site Code
Agent Type
Agent Code
20/03/2011
1D4024375
Agent
1D4019397
Agent Name
SANDIP VITHALBHAI
PATEL
Party Address
Department
C/102, NAVKARDARSHAN
APT BHATAR
Policy Number
Endorsment Number
Insured Name
Client Type
23040011110100000908:
MUSKAN TEXTILES
Organizational 19/07/2011
18/07/2012
23040011110100000912:
Individual
20/07/2011
19/07/2012
23040011110100000913:
Individual
20/07/2011
19/07/2012
23040011110100000940:
Individual
28/07/2011
27/07/2012
23040011110100000941:
Individual
28/07/2011
27/07/2012
23040011110100000798:
Mr. MR.JITENDRA D CHAMPANERIA
Individual
6/7/2011
5/7/2021
23040031110200012425:
Mr. PINKIBEN G. CHAUDHARI -
Individual
4/7/2011
3/7/2012
23040031110200012432:
Mr. PARESHBHAI G. BHAKTA -
Individual
4/7/2011
3/7/2012
23040031110200012675:
Mr. NAVINBHAI P. PATEL -
Individual
7/7/2011
6/7/2012
23040031110200013030:
Mr. SIMRITA LAMBA -
Individual
7/7/2011
6/7/2012
23040031110200013186:
Mr. KISHORE KUMAR SHA .
Individual
8/7/2011
7/7/2012
23040031110200013390:
Mr. KAMLESH C PATEL
Individual
11/7/2011
10/7/2012
23040031110200013397:
Mr. PARESHBHAI G SUTHAR .
Individual
11/7/2011
10/7/2012
23040031110200013826:
Mr. JIGARBHAI M PATEL .
Individual
13/07/2011
12/7/2012
23040031110200013827:
Mr. MAHESHBHAI L PATEL .
Individual
13/07/2011
12/7/2012
23040031110200014205:
Mr. AMJADKHAN B PATHAN .
Individual
15/07/2011
14/07/2012
23040031110100014034:
Mr. RAJU SACHDAV .M.
Individual
16/07/2011
15/07/2012
23040031110200014794:
Mr. HIREN R PRAJAPATI .
Individual
20/07/2011
19/07/2012
23040031110100014783:
Mr. RAMKRISHNA V. KOPPULA -
Individual
21/07/2011
20/07/2012
23040031110200014781:
Mr. NITABEN VINODSINH VANSIYA
Individual
21/07/2011
20/07/2012
23040031110100014456:
Mr. NARENDRA ISHWARSINH ATODARIYA
Individual
22/07/2011
21/07/2012
23040031110100014461:
Mr. HEMENDRASINH J VANSADIYA -
Individual
23/07/2011
22/07/2012
23040031110100015484:
Mr. SURESHBHAI VISABHAI PATEL .
Individual
25/07/2011
24/07/2012
23040031110200015640:
Mr. ASHISHBHAI J PATEL .
Individual
26/07/2011
25/07/2012
Policy Expiry Date
11 Fire
11 Fire Total
31 Motor
Premium Amount
Commission
4533
453
3176
318
1825
183
475
48
3135
314
1350
14494
135
1451
380
925
865
1005
1065
865
380
380
380
380
1948
83
865
2517
145
10385
7985
673
15139
1186
3320
221
380
23040031110200015433:
Mr. SURENDRA S. PATEL -
Individual
27/07/2011
26/07/2012
23040031110200015435:
Mr. JAYANT N PATEL
Individual
27/07/2011
26/07/2012
23040031110200016044:
Mr. REVABHAI M PATEL .
Individual
28/07/2011
27/07/2012
23040031110100015960:
AMITKUMAR J. PATEL
Individual
30/07/2011
29/07/2012
23040034110100001935:
PATEL ALPESHKUMAR NAROTTAMBHAI
Individual
30/06/2011
1/6/2012
23040034110600000438:
VITHALBHAI POPATLAL SONI
Individual
22/06/2011
21/06/2012
23040034110100003194:
ATULKUMAR B DADIA
Individual
3/7/2011
2/7/2012
23040034110100003195:
DADIA KAMLESH B.
Individual
4/7/2011
3/7/2012
23040034110100003157:
BABUBHAI GANESHDAS PATEL
Individual
5/7/2011
4/7/2012
23040034110100003250:
GIRISHBHAI L GOYANI
Individual
7/7/2011
6/7/2012
23040034110100003651:
JIGNASHA SUNILKUMAR BHAGAT.
Individual
11/7/2011
10/7/2012
23040034110100003771:
PANKAJBHAI N CHAUHAN
Individual
15/07/2011
14/07/2012
23040034110100003701:
PATEL BHAVINA YATIN
Individual
16/07/2011
15/07/2012
23040034110100003803:
HITESH SHASHIKANT JARIWALA.
Individual
17/07/2011
16/07/2012
23040034110100003804:
VIPULBHAI GANDUBHAI BHESANIYA
Individual
17/07/2011
16/07/2012
23040034110100003820:
ANIL SHASHIKANT JARIWALA.
Individual
17/07/2011
16/07/2012
23040034110100003964:
DASHRATHBHAI P. PATEL
Individual
19/07/2011
18/07/2012
23040034110100003979:
PRAHLADBHAI P. PATEL.
Individual
19/07/2011
18/07/2012
23040034110100003968:
NIKUNJ H DESAI
Individual
20/07/2011
19/07/2012
23040034110100004128:
MANISH MATADEEN BAJAJ
Individual
22/07/2011
21/07/2012
23040034110100004191:
Mr. KAMLESHBHAI BHANUBHAI RAVAL -
Individual
25/07/2011
24/07/2012
23040034110100003872:
PRATIK K. SHAH
Individual
26/07/2011
25/07/2012
23040034110100004033:
MR. KISHORBHAI DIPCHAND SHAH.
Individual
26/07/2011
25/07/2012
23040034110100004100:
RAJU KWANI
Individual
27/07/2011
26/07/2012
23040034110100004130:
MR. SUMERSINGH SWAMI.
Individual
27/07/2011
26/07/2012
23040034110100004296:
CHHAOCHHARIA PRAMOD
Individual
30/07/2011
29/07/2012
23040034110100004491:
Mr. SANJAYBHAI PRAHLADBHAI PATEL
Individual
30/07/2011
29/07/2012
23040034110100004298:
JAYVADAN RATILAL PATEL
Individual
1/8/2011
31/07/2012
23040034110100004443:
KUNDANBHAI JAYANTIBHAI PATEL.
Individual
3/8/2011
2/8/2012
31 Motor Total
34 Health Insurance
1065
865
380
6308
57782
499
2807
248
185
11850
1778
12262
1839
11830
1775
5140
771
5486
823
5140
771
1300
195
4910
737
3587
538
4938
741
8946
1342
9738
1461
5140
771
3587
538
3510
527
2340
351
7335
1100
6968
1045
3573
536
5904
886
4910
737
4158
624
2340
351
23040034110100004446:
MR. JAYANTILAL ISHWARLAL PATEL.
Individual
3/8/2011
2/8/2012
23040042110100001443:
ATUL B DADIA
Individual
3/7/2011
2/7/2012
23040042110100001444:
DADIA KAMLESH B
Individual
7/7/2011
6/7/2012
23040042110100001707:
VIPULBHAI GANDUBHAI BHESANIYA
Individual
18/07/2011
17/07/2012
23040042110100001926:
PRAMOD CHHAOCHHARTA
Individual
30/07/2011
29/07/2012
23040042110100002000:
KUNDANBHAI J. PATEL.
Individual
31/07/2011
30/07/2012
23040042110100002001:
PATEL JAYANTILAL I.
Individual
31/07/2011
30/07/2012
Insured Name
Client Type
Policy Expiry Date
Individual
31/07/2011
30/07/2012
Grand Total
Site Code
Agent Type
Agent Code
602-795168
17/11/2011
1D4024378
Agent
1D4019400
Agent Name
RAJENDRA NARSINHBHAI
SONDAGAR
Party Address
Department
1491, ASHAPUR SOCIETY

KANAXPUR,
GUJ.HSG.BOARD AT:
SACHIN, DIST: SURAT
Policy Number
Endorsment Number
11 Fire
23040011110100000955:
11 Fire Total
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
602-2078984
22/08/2011
1D4024379
Agent
1D4019401
BINA R SHAH
Party Address
Department
301, SUBHAM
APPARTMENT - 1 OPP. ARIHANT PARK, PARLE
POINT AMBICA NIKETAN
ROAD, SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
31 Motor
23040031110100013078:
Mr. KARANSINGH B DEORA
Individual
11/7/2011
10/7/2012
23040034110100003768:
PARAS PRADEEPBHAI SHETH
Individual
16/07/2011
15/07/2012
23040034110100003697:
CHIRAG RAJSANG CHAUDHRY.
Individual
25/07/2011
24/07/2012
23040034110100003717:
BHAVIN J. THAKKAR.
Individual
27/07/2011
26/07/2012
23040034110100003957:
Mr. RAJESH M PATEL -
Individual
28/07/2011
27/07/2012
23040034110100003696:
HEMRAJ RAJSANG CHAUDHRY.
Individual
30/07/2011
29/07/2012
31 Motor Total
34 Health Insurance
5490
140382
824
21494
923
138
1432
215
1037
156
243
36
468
70
468
4571
217229
70
685
26437
Premium Amount
27584
27584
27584
Premium Amount
Commission
2758
2758
2758
Commission
12687
12687
934
934
4883
732
4987
748
6924
346
6440
966
3725
559
23040034110100004318:
NILESH KANTILAL SHAH
Individual
2/8/2011
1/8/2012
23040048110500000092:
Mr. MANJULABEN J MASHRU & BHAVIN J

THAKKAR
Individual
26/07/2011
25/07/2012
23040048111000000007:
Mr. BHAVIN J THAKKAR -
Individual
26/07/2011
25/07/2012

Grand Total
Site Code
Agent Type
Agent Code
Agent Name
445108
22/02/2014
1D4024473
Agent
1D4019495
SATISH PAREKH
Party Address
Department
78 , SNEHSMRUTI
SOCIETY ADAJAN PATIA
RANDER ROAD
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110200011986:
Mr. AJAY SOHENSINH RAJPUT
Individual
3/7/2011
2/7/2012
23040031110100012846:
Mr. LOKESH TEX TRADE P. LTD.
Individual
14/07/2011
13/07/2012
23040031110100014372:
Mr. URVASHI B. PATEL -
Individual
23/07/2011
22/07/2012
23040031110100014375:
Mr. BHARATBHAI PATEL -
Individual
23/07/2011
22/07/2012
23040031110200014366:
Mr. SUNIL.K ADVANI
Individual
23/07/2011
22/07/2012
23040031110200014369:
Mr. BHARAT F. PATEL
Individual
23/07/2011
22/07/2012
9869
36828
1480
4831
3254
488
1031
4285
53800
155
643
6408
Premium Amount
450
3223
52
810
36
758
31
31 Motor
31 Motor Total
34 Health Insurance
23040034110100004482:
MR. RASIK V. PATEL.
Individual
1/8/2011
31/07/2012
23040048110600000196:
Mr. SHREENATH FAB
Individual
8/7/2011
7/7/2012

Grand Total
Site Code
Agent Type
Agent Code
Agent Name
644862
24/07/2011
1D4024482
Agent
1D4019504
HARESH H AMBALIYA
Party Address
Department
A-15 , HARIOM SOCIETY ,

KATARGAM ROAD SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
11 Fire
23040011110100000956:
KHODAL BHAVANI ART
Individual
25/07/2011
24/07/2012
23040031110100012473:
VIJAYBHAI S DHAMELIA
Individual
6/7/2011
5/7/2012
23040031110100013380:
Mr. LALJIBHAI D DEVGANIA
Individual
12/7/2011
11/7/2012
23040031110100013381:
Mrs. REKHABEN JASHMATBHAI VIDIYA
Individual
14/07/2011
13/07/2012
23040031110100014376:
RAMESHBHAI. D. KALSARIYA.
Individual
20/07/2011
19/07/2012
11 Fire Total
31 Motor
Commission
450
450
6141
119
4455
4455
668
668
2680
2680
13276
402
402
1189
Premium Amount
Commission
1015
1015
87
87
530
15
594
21
673
29
3605
235
31 Motor
23040031110100012471:
Mr. BHARATBHAI .P. PATEL
Individual
24/07/2011
23/07/2012
23040031110100016241:
Mr. DINESHBHAI D SARVAIYA
Individual
3/8/2011
2/8/2012
23040034111900000351:
MR. RAJESHBHAI D. SONDAGAR
Individual
4/7/2011
3/7/2012
23040034111900000352:
MR. DHANJIBHAI B. SONDAGAR.
Individual
4/7/2011
3/7/2012
23040034111900000353:
Mr. PRAKASHBHAI KANTIBHAI MISTRY -
Individual
4/7/2011
3/7/2012
23040034111900000354:
Mr. ASWINBHAI HARIBHAI -
Individual
4/7/2011
3/7/2012
23040034111900000356:
Mr. AMITBHAI RAMANIKBHAI UNAGAR -
Individual
4/7/2011
3/7/2012
23040034110100003331:
Mr. VAKARIYAVRAJLAL DAMJIBHAI -
Individual
5/7/2011
4/7/2012
23040034111900000327:
Mr. VINUBHAI HADABHAI VARIYA -
Individual
5/7/2011
4/7/2012
23040034111900000328:
Mr. VINODBHAI MERAMANBHAI VARIYA -
Individual
5/7/2011
4/7/2012
23040034111900000329:
Mr. BHIKHABHAI M PIPALIYA -
Individual
5/7/2011
4/7/2012
23040034111900000330:
Mr. PARESHBHAI JIVRAJBHAI TARSARIYA -
Individual
5/7/2011
4/7/2012
23040034111900000331:
Mr. MULAJIBHAI JADAVBHAI UNAGAR -
Individual
5/7/2011
4/7/2012
23040034111900000332:
Mr. MEHUL JUGALBHAI VYAS -
Individual
5/7/2011
4/7/2012
23040034111900000333:
Mr. PRAVIN VITTHALBHAI RAVAL -
Individual
5/7/2011
4/7/2012
23040034111900000334:
Mr. CHETANBHAI KANTIBHAI MISTRY -
Individual
5/7/2011
4/7/2012
23040034111900000335:
Mr. RAMESHBHAI VIRAJBHAI KAKLOTTAR -
Individual
5/7/2011
4/7/2012
23040034111900000370:
Mr. SONDAGAR ASHOK SHAMBUBHAI -
Individual
6/7/2011
5/7/2012
23040034110100003327:
Mr. AMBELIYA DIPAK N -
Individual
7/7/2011
6/7/2012
23040034110100003329:
AAMBALIA CHAGANBHAI VITTHALBHAI
Individual
7/7/2011
6/7/2012
23040034110100003330:
AAMBALIA NATWARLAL VITHTHALBHAI
Individual
7/7/2011
6/7/2012
23040034110100003448:
Mr. GABANI ANILBHAI PRASOTTAMBHAI -
Individual
7/7/2011
6/7/2012
23040034110100003449:
Mr. GABANI JITESH PARSOTTAMBHAI -
Individual
7/7/2011
6/7/2012
23040034111900000350:
VYAS JUGALBHAI MEGHJIBHAI
Individual
7/7/2011
6/7/2012
23040034111900000358:
MALANKIA ARVIND HARIBHAI
Individual
7/7/2011
6/7/2012
23040034111900000373:
Mr. PRASOTTAMBHAI LAVJIBHAI GABANI -
Individual
7/7/2011
6/7/2012
23040034110600000529:
GHANSHYAMBHAI KALUBHAI MALAVIYA
Individual
8/7/2011
7/7/2012
23040034110600000530:
JAYANTIBHAI BACHUBHAI MALAVIYA
Individual
8/7/2011
7/7/2012
23040034110600000531:
ASHOKBHAI NANUBHAI BHADANI
Individual
8/7/2011
7/7/2012
31 Motor Total
8611
736
573
14586
19
1055
548
82
548
82
548
82
548
82
548
82
1300
195
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
730
110
548
82
4834
725
7132
1070
6831
1025
1300
195
3587
538
548
82
548
82
548
82
2565
385
3315
497
2700
405
34 Health Insurance
23040034110600000532:
BHAILALBHAI SAVJIBHAI MALAVIYA
Individual
8/7/2011
7/7/2012
23040034111900000336:
VALLABHBHAI RAGHAVBHAI KACHARIYA
Individual
8/7/2011
7/7/2012
23040034111900000338:
RAVJIBHAI RAMJIBHAI JANJMERA
Individual
8/7/2011
7/7/2012
23040034111900000339:
JAYANTIBHAI ZINABHAI VARIYA
Individual
8/7/2011
7/7/2012
23040034111900000359:
MANUBHAI KARSANBHAI VYAS
Individual
8/7/2011
7/7/2012
23040034111900000360:
RASILABEN JIVANBHAI KALSARIYA
Individual
8/7/2011
7/7/2012
23040034111900000362:
MR. MANANBHAI MOHANBHAI VAGHELA
Individual
8/7/2011
7/7/2012
23040034111900000367:
SHAMBHUBHAI NANJIBHAI MALAVIYA
Individual
8/7/2011
7/7/2012
23040034111900000368:
MADHUBHAI SAVJIBHAI MALAVIYA
Individual
8/7/2011
7/7/2012
23040034111900000369:
ASHABEN NATHABHAI SUHAGIYA
Individual
8/7/2011
7/7/2012
23040034111900000371:
BHARATBHAI BHIKHABHAI AMBALIYA
Individual
8/7/2011
7/7/2012
23040034111900000372:
Mr. PRADEEPBHAI BHARATBHAI AMBALIYA -
Individual
8/7/2011
7/7/2012
23040034111900000375:
MR. BAVCHANDBHAI J. VORA
Individual
8/7/2011
7/7/2012
23040034111900000341:
KHIMJIBHAI JIVRAJBHAI PATEL.
Individual
9/7/2011
8/7/2012
23040034111900000342:
KIRANBHAI KHIMJIBHAI PATEL.
Individual
9/7/2011
8/7/2012
23040034111900000343:
DHANSUKHABHAI KHIMJIBHAI PATEL.
Individual
9/7/2011
8/7/2012
23040034111900000349:
MR. VIJAYBHAI KANTILAL THAKKAR.
Individual
9/7/2011
8/7/2012
23040034111900000355:
HARJIBHAI RAMBHAI KACHRIYA
Individual
9/7/2011
8/7/2012
23040034111900000357:
CHHAGANBHAI RAMBHAI KACHRIYA
Individual
9/7/2011
8/7/2012
23040034111900000376:
Mr. DEEP FASHION -
Individual
11/7/2011
10/7/2012
23040034111900000378:
Mr. PARESHBHAI DINESHBHAI KAKLOTTAR -
Individual
12/7/2011
11/7/2012
23040034111900000379:
Mr. DINESHBHAI PARSOTTAMBHAI KAKLOTAR -
Individual
12/7/2011
11/7/2012
23040034111900000366:
DILKHUSHBHAI RAMESHBHAI AMBALIYA
Individual
13/07/2011
12/7/2012
23040034111900000374:
DHIRUBHAI BHIMJIBHAI GHOGHARI
Individual
13/07/2011
12/7/2012
23040034111900000377:
CHHAGANBHAI H. GHOGHARI
Individual
13/07/2011
12/7/2012
23040034111900000382:
Mr. ISHVAR B DEVGANIYA -
Individual
13/07/2011
12/7/2012
23040034111900000337:
KIRANBHAI GUNVANTBHAI GHOGHARI
Individual
14/07/2011
13/07/2012
23040034111900000344:
HITESHBHAI GUNVANTBHAI GHOGHARI
Individual
14/07/2011
13/07/2012
23040034111900000345:
MAYURBHAI GUNVANTBHAI GHOGHARI
Individual
14/07/2011
13/07/2012
23040034111900000361:
MR. MANSUKHBHAI N AJUGIYA
Individual
14/07/2011
13/07/2012
1458
219
548
82
548
82
548
82
548
82
548
82
730
110
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
365
55
365
55
730
110
548
82
548
82
548
82

Grand Total
Site Code
Agent Type
Agent Code
Agent Name
23040034111900000347:
PRAKASHBHAI KURJIBHAI AMBALIYA
Individual
15/07/2011
14/07/2012
23040034110100003767:
VIDIYA VINUBHAI NANUBHAI
Individual
16/07/2011
15/07/2012
23040034110100003733:
GABANI RAMESHBHAI THAKARSHIBHAI
Individual
18/07/2011
17/07/2012
23040034110600000600:
BHAVNA S. SHROFF
Individual
18/07/2011
17/07/2012
23040034111900000387:
Mr. VARIYA DULABHAI MADHUBHAI -
Individual
19/07/2011
18/07/2012
23040034111900000388:
Mr. VARIYA RAJANIKANT DULABHAI -
Individual
19/07/2011
18/07/2012
23040034111900000389:
Mr. VARIYA NARESHBHAI DULABHAI -
Individual
19/07/2011
18/07/2012
23040034111900000390:
Mr. VARIYA MAHESHBHAI DULABHAI -
Individual
19/07/2011
18/07/2012
23040034111900000391:
Mr. AMBALIYA AMARSHIBHAI ZINABHAI -
Individual
19/07/2011
18/07/2012
23040034110100003731:
MR. KANJIBHAI THAKARSHIBHAI GABANI.
Individual
20/07/2011
19/07/2012
23040034110100003732:
GABANI CHETANBHAI THAKARSHIBHAI
Individual
20/07/2011
19/07/2012
23040034111900000346:
NITESH UKABHAI VYAS
Individual
21/07/2011
20/07/2012
23040034111900000364:
MR. RAVJIBHAI D AMBALIYA
Individual
21/07/2011
20/07/2012
23040034111900000365:
MR. RAMESHBHAI D PRAJAPATI
Individual
21/07/2011
20/07/2012
23040034111900000348:
RAJNIKANTBHAI K AMBALIYA
Individual
22/07/2011
21/07/2012
23040034111900000385:
MR. PRAVINBHAI MEPABHAI PANDAV.
Individual
27/07/2011
26/07/2012
23040034111900000386:
MR. KISHORBHAI MEPABHAI PANDAV.
Individual
27/07/2011
26/07/2012
23040034111900000340:
GOPALBHAI RAMJIBHAI PRAJAPATI
Individual
29/07/2011
28/07/2012
23040034111900000363:
BHARATBHAI P VORA
Individual
30/07/2011
29/07/2012
23040034110100004480:
PATEL DIPESH JITENDRABHAI
Individual
3/8/2011
2/8/2012
23040034110100004481:
PATEL HEMISH JITENDRABHAI
Individual
3/8/2011
2/8/2012
23040034110600000762:
VALLABHBHAI P. DHANDHUKIYA.
Individual
3/8/2011
2/8/2012
23040034110600000763:
DILIPBHAI MANSUKHBHAI TARSARIYA
Individual
3/8/2011
2/8/2012
23040034110600000764:
ASHOKBHAI MANSUKHBHAI TARASRIYA
Individual
3/8/2011
2/8/2012
23040034111900000403:
Mr. MANSUKHABHAI TARSARIYA -
Individual
3/8/2011
2/8/2012
23040034111900000404:
MR. DEVSHIBHAI HIRJIBHAI RAVAL
Individual
4/8/2011
3/8/2012
IRDA-644862
24/07/2011
1D4024482
Agent
1D4019504
HARESH H AMBALIYA
548
82
7830
1175
2340
351
2520
378
548
82
548
82
548
82
548
82
548
82
4757
714
4680
702
548
82
548
82
548
82
548
82
548
82
548
82
548
82
548
82
4895
734
6470
971
5045
757
1935
290
1260
189
548
82
548
111458
127059
82
16711
17853
Party Address
Department
A-15 , HARIOM SOCIETY ,

KATARGAM ROAD SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
31 Motor
23040031100100012749:
23040031110183000113:
Mr. HIMMATBHAI J TARSARIYA
Individual
5/7/2011
14/10/2011
31 Motor Total
Grand Total
Site Code
Agent Type
Agent Code
1719971
23/06/2013
1D4024519
Agent
1D4019541
Agent Name
DINESH CHELDAS PATEL
Party Address
Department
EC-12-D, SHIV TOWER,

PRAMUKH PARK
RESIDENT, NR. ITI
COLLEGE PANDESARA,
BHEDWAD
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100003370:
PATEL GAUTAMBHAI C.
Individual
9/7/2011
8/7/2012
23040034110100003459:
PATEL MAHESHKUMAR DASHARATHBHAI
Individual
12/7/2011
11/7/2012
23040034110100003518:
MR. JAYESH HARGOVANDAS PATEL.
Individual
16/07/2011
15/07/2012
23040034110100003520:
PATEL SANJAYBHAI HARGOVANDAS
Individual
16/07/2011
15/07/2012
23040034110100003235:
PATEL ARVINDBHAI V
Individual
20/07/2011
19/07/2012
23040034110100003628:
PATEL MAHESHBHAI V.
Individual
20/07/2011
19/07/2012
23040034110100003630:
PATEL KANUBHAI MANILAL
Individual
24/07/2011
23/07/2012
23040034110100004306:
PATEL HARGOVINDBHAI AMTHABHAI
Individual
28/07/2011
27/07/2012
23040034110100004309:
MODI CHANDRESHKUMAR SANMUKHLAL
Individual
28/07/2011
27/07/2012
23040034110100004310:
PUROHIT SURESHBHAI PRATAPMAL
Individual
29/07/2011
28/07/2012
34 Health Insurance

Grand Total
Site Code
Agent Type
Agent Code
1372799
1/9/2012
1D4024526
Agent
1D4019548
Agent Name
KETAN BABUBHAI
SHIHORA
Party Address
Department
A-2, GAYATRI PARIWAR

-2, KATARGAM ROAD,
SURAT.
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100003673:
Ms. ASHABEN TALSHIBHAI SUTARIYA -
Individual
11/7/2011
10/7/2012
23040034110100003238:
Mr. JAGDISHBHAI NARSHIBHAI MANGUKIYA -
Individual
21/07/2011
20/07/2012
34 Health Insurance
Premium Amount
Commission
296
296
296
Premium Amount
28
28
28
Commission
3587
538
4680
702
5828
874
4158
624
7271
1091
5140
771
4680
702
7812
1172
8019
1203
8261
59436
59436
1239
8916
8916
Premium Amount
Commission
1300
195
2340
351
34 Health Insurance
23040034110600000711:
Mr. RAMESHBHAI BALABHAI MENDAPARA -
Individual
23/07/2011
22/07/2012
23040034110600000706:
Mr. BALABHAI NANUBHAI MENDAPARA -
Individual
27/07/2011
26/07/2012
23040034110600000712:
Mr. SHAILESH BALABHAI MENDAPARA -
Individual
27/07/2011
26/07/2012
23040042110100001529:
Mr. RAJESH SAVJIBHAI SUTARIYA -
Individual
6/7/2011
5/7/2012
23040042110100001530:
Mr. LALJIBHAI SAVAJIBHAI SUTARIYA -
Individual
6/7/2011
5/7/2012
23040042110100001531:
Mr. DHANANJAY LALJIBHAI SUTARIYA -
Individual
6/7/2011
5/7/2012
23040042110100001624:
AMIT SHAMBHUBHAI MANIYA
Individual
11/7/2011
10/7/2012
23040042110100001625:
MEHUL SHAMBHUBHAI MANIYA
Individual
11/7/2011
10/7/2012
23040042110100001626:
ANKIT SHAMBHUBHAI MANIYA
Individual
11/7/2011
10/7/2012
Grand Total
Site Code
Agent Type
Agent Code
1501494
2/12/2009
1D4024528
Agent
1D4019550
Agent Name
HIMATLAL MOHANBHAI
SOHAGIA
Party Address
Department
B/203, SARGAM
APPARTMENT DOCTOR
HOUSE, HIRA BAUGH
VARACHHA ROAD
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100012185:
Mr. PRAVINBHAI .P. SURANI
Individual
6/7/2011
5/7/2012
23040031110100013642:
SOHAGIA MAHENDRABHAI MOHANBHAI
Individual
18/07/2011
17/07/2012
23040031110200015595:
MANUBHAI PREMJIBHAI VADDORIYA
Individual
4/8/2011
3/8/2012
23040034110600000546:
LALJIBHAI BHIMJIBHAI KATHIRIYA
Individual
9/7/2011
8/7/2012
23040034110300000163:
KAMLESH DHIRUBHAI KHUNT
Individual
18/07/2011
17/07/2012
23040034110100003960:
MR. SURESHBHAI BABUBHAI NAKARANI.
Individual
24/07/2011
23/07/2012
23040034110100003963:
MR. LALITBHAI N. DOBARIYA.
Individual
27/07/2011
26/07/2012
23040034110100004257:
NASIT VINUBHAI POPATBHAI
Individual
31/07/2011
30/07/2012
23040034110100004326:
NILESHBHAI SAVJIBHAI SACHANI
Individual
3/8/2011
2/8/2012
23040034110100004333:
SAVJIBHAI NAGJIBHAI SACHANI
Individual
3/8/2011
2/8/2012
31 Motor
31 Motor Total
34 Health Insurance

Grand Total
Site Code
Agent Type
1691654
25/05/2013
1D4024530
Agent
2610
392
2520
378
2010
10780
302
1618
1539
231
1539
231
900
135
312
47
312
47
312
4914
15694
47
738
2356
Premium Amount
Commission
641
26
470
380
1491
35
2610
392
4542
681
5490
824
4938
741
6831
1025
4757
714
6624
35792
37283
994
5371
5406
Agent Code
1D4019552
Agent Name
RAJENDRA RAMANLAL
JARIWALA
Party Address
Department
17, SHIVBHAKTIPARK,
OPP -SHAKTINAGAR,
HARINAGAR -3, UDHNA,
SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100014778:
AJMALSINH M. JADAV
Individual
24/07/2011
23/07/2012
23040031110100014780:
AJABSINGH M. JADAV
Individual
24/07/2011
23/07/2012
23040031110200014777:
AJMALSING
Individual
24/07/2011
23/07/2012
31 Motor
31 Motor Total
23040034111900000326:
Mr. PRAKASH GORAKH PATIL -
Individual
1/7/2011
30/06/2012
23040034110100004163:
BHAVANIWALA DIPAK D
Individual
27/07/2011
26/07/2012
23040034110100004083:
MR. AMRUT VANAMALI MISTRY.
Individual
30/07/2011
29/07/2012
23040034110100004269:
MANISH PRAVINCHANDRA JARIWALA.
Individual
30/07/2011
29/07/2012
34 Health Insurance

Grand Total
Site Code
Agent Type
Agent Code
1690166
24/05/2013
1D4024531
Agent
1D4019553
Agent Name
NILESHKUMAR
CHANDRAKANT
SAKARSAWALA,
Party Address
Department
B/3, DARBAR NAGAR

SOCIETY VED ROAD,
SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
34 Health Insurance
23040034110100003726:
SHANKARBHAI GOPALDAS VADHVANI
Individual
19/07/2011
18/07/2012

Grand Total
Site Code
Agent Type
Agent Code
1642017
23/03/2010
1D4024533
Agent
1D4019555
Agent Name
RAJESH VINODCHANDRA
TAMAKUWALA
Party Address
Department
1, CHINTAN
APPARTMENTS, NR.
BHUMI COMPLEX, PATEL
PRAGATI WADI ROAD
ADAJAN
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100013174:
Mr. KISHORBHAI C. PATEL -
Individual
10/7/2011
9/7/2012
23040031110100016101:
NAGINBHAI C PATEL
Individual
30/07/2011
29/07/2012
23040031110100016100:
Mr. SHANTANU S. CHANDA -
Individual
31/07/2011
30/07/2012
31 Motor
Premium Amount
Commission
554
17
559
18
380
1493
35
548
82
6831
1025
1850
278
5256
14485
15978
788
2173
2208
Premium Amount
Commission
3817
3817
3817
Premium Amount
573
573
573
Commission
615
17
607
16
6793
553
31 Motor Total
34 Health Insurance
23040034110100003334:
PRADEEP MUKUND JOSHI.
Individual
6/7/2011
5/7/2012
23040034110100003488:
SHAILESH V. PATEL.
Individual
11/7/2011
10/7/2012
23040034110100003549:
MR. PATIL BHUPENDRA
Individual
11/7/2011
10/7/2012
23040034110100003550:
SHASHIKANT V. VANMALI./PATEL
Individual
11/7/2011
10/7/2012
23040034110100004172:
MR. NAINESH R. BUTTI.
Individual
24/07/2011
23/07/2012
23040034110100004180:
MR. DIVYESH R. BUTTI
Individual
24/07/2011
23/07/2012
23040034110100004325:
MR. SHANTANU CHANDA.
Individual
27/07/2011
26/07/2012
23040034110100004483:
BHARAT UTTAMBHAI MISTRY.
Individual
31/07/2011
30/07/2012
23040034110100004485:
KIRAN KUNDANBHAI VYAS.
Individual
7/8/2011
6/8/2012
23040042110100001876:
MR. KIRITKUMAR CHHAGANLAL DESAI.
Individual
24/07/2011
23/07/2012
23040042110100002016:
KIRAN KUNDANBHAI VYAS.
Individual
7/8/2011
6/8/2012
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
109299
7/5/2013
1D4024760
Agent
1D4019782
HEMANT KUMAR
Party Address
Department
B-1/68, KAILASH NAGAR

SOCIETY SAGRAMPURA
SURAT
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100004120:
Dr. MUKESH P JAGIWALA
Individual
1/6/2011
31/05/2012
23040034110600000521:
RANJITBHAI CHANDULAL GANJAWALA.
Individual
5/7/2011
4/7/2012
23040034110100003622:
MR. NARESH D. GHEEWALA.
Individual
20/07/2011
19/07/2012
23040034110100003624:
FORAM NARESH GHEEWALA.
Individual
20/07/2011
19/07/2012
23040034110100003638:
Mr. JENISH NARESH GHEEWALA -
Individual
20/07/2011
19/07/2012
23040034110100003941:
MUKESH DHANSUKHLAL GHEEWALA.
Individual
20/07/2011
19/07/2012
23040034110300000170:
BISHNUKUMAR TULSYAN
Individual
20/07/2011
19/07/2012
23040042110100001603:
MUKESH DHANSUKHLAL GHEEWALA.
Individual
20/07/2011
19/07/2012
23040042110100001605:
NARESH D. GHEEWALA.
Individual
20/07/2011
19/07/2012
23040042110100001606:
Mr. JENISH N GHEEWALA -
Individual
20/07/2011
19/07/2012
23040042110100001760:
FORAM N. GHEEWALA.
Individual
20/07/2011
19/07/2012
34 Health Insurance
8015
586
9326
1399
5250
788
3740
561
5486
823
2595
389
2595
389
5735
860
4757
714
1300
40784
195
6118
150
23
400
550
49349
60
83
6787
Premium Amount
Commission
30316
1516
3690
185
16890
2534
9936
1490
6516
977
23095
3464
5981
96424
897
11063
1080
162
972
146
702
105
729
3483
109
522
Grand Total
Site Code
Agent Type
Agent Code
1423124
31/12/2006
1D4317830
Agent
1D4312663
Agent Name
BHAVESH HIMATBHAI
PATEL
Party Address
Department
122, VANDANA SOCIETY,

VIBHAG-2 NEAR BHID
BHANJAN SOC. VIBHAG2, NANA VARACHHA,
SURAT-395 006 69303
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100012829:
DAMJIBHAI BECHARBHAI GOYANI
Individual
10/7/2011
9/7/2012
23040031110100013640:
SHAILESHBHAI BABUBHAI BORDA
Individual
25/07/2011
24/07/2012
23040031110100016095:
RAMESHBHAI B SAVANI
Individual
1/8/2011
31/07/2012
23040034110100003551:
Mr. SAVANI BHARATBHAI VALLABHBHAI -
Individual
8/7/2011
7/7/2012
23040034110100003554:
Mr. ANILBHAI VALLABHBHAI SAVANI -
Individual
8/7/2011
7/7/2012
23040034110100003556:
Mr. SAVANI LALJIBHAI VALLABHBHAI -
Individual
8/7/2011
7/7/2012
23040034110100003967:
Mr. BODAR N KIRITBHAI KANAIYALAL -
Individual
20/07/2011
19/07/2012
23040034110100003702:
MANSUKHBHAI V GOYANI
Individual
23/07/2011
22/07/2012
23040034110100003714:
NIKUNJKUMAR D SAVANI
Individual
25/07/2011
24/07/2012
23040034110100003715:
MANOJKUMAR D SAVANI
Individual
25/07/2011
24/07/2012
23040034110100004063:
PARTH L SAVANI
Individual
5/8/2011
4/8/2012
23040034110100004067:
DHANJIBHAI RANCHHOD SAVANI.
Individual
5/8/2011
4/8/2012
23040034110100004069:
LALJIBHAI RANCHHODBHAI SAVANI.
Individual
5/8/2011
4/8/2012
23040042110100001776:
Mr. BODAR KIRITBHAI KANAIYALAL -
Individual
19/07/2011
18/07/2012
23040042110100001650:
ALPESH H. PATEL
Individual
20/07/2011
19/07/2012
23040042110100001647:
MR.DHANJIBHAI BHAGVANBHAI PRAJAPATI
Individual
23/07/2011
22/07/2012
23040042110100001807:
MR.KANUBHAI BECHARBHAI PATEL
Individual
23/07/2011
22/07/2012
31 Motor
99907
31 Motor Total
34 Health Insurance
Grand Total
Site Code
Agent Type
Agent Code
1349985
18/08/2012
SI00001336
Agent
AG00000421
Agent Name
Mr. SANJAY SURENDRA

ALMAULA
Premium Amount
11585
Commission
664
21
606
16
515
1785
14
51
1300
195
1300
195
4895
734
4757
714
4672
701
2340
351
4972
746
2340
351
5598
840
6768
38942
1015
5842
180
27
180
27
180
27
180
720
41447
27
108
6001
Party Address
Department
31 Motor
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100013197:
Mr. GULNAZ NAUSHA DALI SAYEED
Individual
11/7/2011
10/7/2012
23040031110100014486:
Mr. HARISH D. CHAUHAN -
Individual
19/07/2011
18/07/2012
23040031110100015901:
Mr. SEJAL BHADRABAHU SHAH .
Individual
28/07/2011
26/07/2012
23040034110100004431:
Mr. ASHVINKUMAR PARSOTTAMBHAI PATEL
Individual
28/07/2011
27/07/2012
23040042110100001998:
Mr. ASHVINKUMAR PARSOTTAMBHAI PATEL
Individual
28/07/2011
27/07/2012
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110600000520:
Mr. ARUN RAMANBHAI PATEL -
Individual
1/7/2011
30/06/2012
23040034110100003236:
Ms. PATEL DAMYANTIBEN GUMAN BHAI -
Individual
4/7/2011
3/7/2012
23040034110100003309:
PARMAR RAJESHKUMAR DHIRAJLAL
Individual
14/07/2011
13/07/2012
23040034110600000549:
AJAYKUMAR TULSIDAS JARIWALA
Individual
20/07/2011
19/07/2012
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100003988:
KAILASHBHAI BHAGWANBHAI BIRADI
Individual
21/07/2011
20/07/2012
23040042110100001785:
KAILASHBHAI BHAGWANBHAI BIRADI
Individual
21/07/2011
20/07/2012
23040042110100001786:
JAYESHBHAI DEVIDAS PATIL
Individual
24/07/2011
23/07/2012
31 Motor Total
34 Health Insurance
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
Agent Name
Party Address
Department
34 Health Insurance
Agent Name
Party Address
697
32
588
21
802
2087
35
88
1300
1300
195
195
180
180
3567
27
27
310
Mr. JAYESHKUMAR
NATVARLAL RANA
Premium Amount
Commission
1260
189
1300
195
2340
351
2565
7465
7465
385
1120
1120
892374
6/12/2011
SI00021888
Agent
AG00010013
Mr. KAILASH BHAGWAN
BIRADI
Grand Total
Site Code
Agent Type
Agent Code
Commission
2440247
6/6/2012
SI00002535
Agent
AG00000451
34 Health Insurance

Grand Total
Site Code
Agent Type
Agent Code
Premium Amount
2906175
7/1/2013
SI00021990
Agent
AG00010101
Mr. JIGNESH MOHANLAL
PATEL
Premium Amount
Commission
10369
10369
1555
1555
1944
292
540
2484
12853
81
373
1928
Department
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
31 Motor
23040031110200014769:
MR.C. SURENDRAN.
Individual
24/07/2011
23/07/2012
31 Motor Total
Grand Total
Site Code
Agent Type
Agent Code
3662234
22/10/2013
SI00024645
Agent
AG00011175
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100013653:
PARITABEN KISHORBHAI MANIYA
Individual
13/07/2011
12/7/2012
34 Health Insurance
23040034110100004014:
ASHWIN V SAVANI
Individual
23/07/2011
22/07/2012

Grand Total
Site Code
Agent Type
Agent Code
4938703
20/12/2011
SI00023826
Agent
AG00011427
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
34 Health Insurance
23040034110100003409:
Mr. DUMASIA KINTKUMAR NAGINDAS -
Individual
19/07/2011
5/7/2012

Grand Total
Site Code
Agent Type
Agent Code
675222
13/09/2011
SI00028861
Agent
AG00014088
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100013038:
Mr. JUGAL K. SHARMA -
Individual
7/7/2011
6/7/2012
23040034110100003639:
Mr. HARISH KUMAR SHARMA -
Individual
11/7/2011
10/7/2012
23040034110100003640:
Mr. KISHOR KUMAR N SHARMA -
Individual
11/7/2011
10/7/2012
23040042110100001676:
Mr. NANDLAL SHARMA -
Individual
14/07/2011
13/07/2012
23040042110100001677:
Mr. HARISH KUMAR SHARMA -
Individual
14/07/2011
13/07/2012
Agent Name
Party Address
Department
31 Motor
Premium Amount
380
380
380
Mr. BRIJESH
CHHAGANBHAI
VANPARIYA
Premium Amount
Agent Name
Party Address
Department
31 Motor
14
14
4834
4834
5349
725
725
739
Mr. SHRINIVAS S
AMANCHI
Premium Amount
Commission
2570
2570
2570
386
386
386
Mr. RAMESH KUMAR

SHARMA
31 Motor Total
34 Health Insurance
Grand Total
Site Code
Commission
515
515
31 Motor Total
Agent Name
Party Address
Department
Commission
5700980
25/08/2012
SI00029468
Premium Amount
Commission
840
840
39
39
1300
195
3725
5025
559
754
522
78
396
918
6783
59
137
930
Agent Type
Agent Code
Agent Name
Party Address
Department
Agent
AG00014507
Mr. HARSHA BIPINBHAI
PAREKH
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100003315:
BIPINBHAI VRAJLAL PAREKH
Individual
6/7/2011
5/7/2012
23040042110100001493:
PAREKH BIPINBHAI VRAJLAL
Individual
6/7/2011
5/7/2012
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
11 Fire
23040011110100001004:
Mr. NEW VRINDAVAN FASHION
Individual
1/8/2011
31/07/2012
11 Fire Total
Grand Total
Site Code
Agent Type
Agent Code
2642020
28/09/2012
SI00029651
Agent
AG00014641
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100003393:
MUKESHBHAI T PANCHAL
Individual
23/07/2011
22/07/2012
23040034110300000148:
PIYUSH .R. SAKALSAWALA.
Individual
23/07/2011
22/07/2012
23040034110100004294:
Mr. NEEL KEYURBHAI PATEL -
Individual
25/07/2011
24/07/2012
23040034110600000653:
RATANLAL CHHOTELALJANGID/SHARMA
Individual
26/07/2011
25/07/2012
23040034110100004311:
AMITBHAI I PRAJAPATI
Individual
30/07/2011
29/07/2012
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040034110100004278:
Mr. JIVACHHA YOGENDRA MUKHIYA -
Individual
25/07/2011
24/07/2012
34 Health Insurance
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
Agent Name
Party Address
Department
34 Health Insurance

Grand Total
Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
34 Health Insurance
Grand Total
Premium Amount
Commission
5832
5832
875
875
243
243
6075
36
36
911
2475254
29/06/2012
SI00029532
Agent
AG00014556
Mrs. MONIKA MUKESH
JARIWALA
Premium Amount
5168
5168
5168
Commission
517
517
517
Mr. PIYUSH
RAMESHCHANDRA
Premium Amount
Commission
5661
849
5981
897
1300
195
3240
486
4757
20939
20939
714
3141
3141
8273277
7/9/2013
SI00032142
Agent
AG00016541
Mr. KALPESHKUMAR
BHUPENDRABHAI
PANDYA
Premium Amount
1300
1300
1300
Commission
195
195
195

Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
11 Fire
8617802
22/05/2014
SI00035628
Agent
AG00019653
Mrs. CHHAYA SANJAY
SIDDHPURIA
Policy Number
Endorsment Number
Client Type
Policy Expiry Date
23040011110100000853:
Insured Name
Individual
14/07/2011
13/07/2012
23040011110100000851:
Individual
15/07/2011
14/07/2012
23040011110100000852:
Individual
15/07/2011
14/07/2012
23040031110100014616:
Mr. HARIBHAI DAHYABHAI AHIR .
Individual
20/07/2011
19/07/2012
23040031110200015985:
Mr. VIPAN K KHUTLAR .
Individual
28/07/2011
27/07/2012
11 Fire Total
31 Motor
31 Motor Total
23040034110100003453:
PANCHAL RAJESHBHAI MANSUKHBHAI
Individual
10/7/2011
9/7/2012
23040034110100003655:
PATEL VIJAY NATVARLAL
Individual
13/07/2011
12/7/2012
23040034110100003609:
MR JAYESHBHAI KHUSHAL BHAI PATEL
Individual
21/07/2011
20/07/2012
23040034110100003918:
SUSHILKUMAR MITTAL
Individual
22/07/2011
21/07/2012
23040034110100003958:
RAJESH DAHYABHAI PATEL
Individual
22/07/2011
21/07/2012
23040034110100003962:
MAMTABEN RAJESHBHAI PATEL
Individual
28/07/2011
27/07/2012
23040042110100001494:
Mr. HAMENT KUMAR DHANSUKHBHAI GANTHAI - Individual
23/07/2011
4/7/2012
23040042110100001608:
MR JAYESHBHAI KHUSHAL BHAI PATEL
Individual
21/07/2011
20/07/2012
23040042110100001737:
SUSHILKUMAR MITTAL
Individual
22/07/2011
21/07/2012
34 Health Insurance
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
Premium Amount
Commission
39602
3060
2505
150
2505
44612
150
3360
14895
860
2935
17830
860
1746
262
4757
714
4910
737
5832
875
7266
1090
4469
28980
670
4348
780
117
486
73
405
1671
93093
61
251
8819
2436655
3/6/2012
SI00036574
Agent
AG00020543
Mr. SHYAMSUNDER
BHANWARLAL LADHA
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
34 Health Insurance
23040034110100003535:
Mr. KAILASHCHANDRA BHATTAR -
Individual
8/7/2011
7/7/2012

Grand Total
Site Code
Agent Type
Agent Code
4779483
2/11/2011
SI00029295
Agent
PO06573051
Premium Amount
5486
5486
5486
Commission
823
823
823
Agent Name
Party Address
Department
Mr. ARVINDKUMAR SINGH

Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
31 Motor
23040031110100012684:
Mr. ARVINDKUMAR SINGH
Individual
5/7/2011
4/7/2012
Policy Number
Endorsment Number
Insured Name
Client Type
Policy Expiry Date
23040031110100012685:
SHIV SHANKAR N GOYAL
Individual
6/7/2011
5/7/2012
23040031110100014209:
SHRI.MITESHKUMAR M .DABHI
Individual
15/07/2011
14/07/2012
23040034110600000598:
PERCY JAL SARAI
Individual
15/07/2011
14/07/2012
31 Motor Total
Grand Total
Site Code
Agent Type
Agent Code
Agent Name
Party Address
Department
31 Motor Total

Grand Total
Commission
923
923
923
47
47
47
Direct
31 Motor
34 Health Insurance
Premium Amount
Premium Amount
2154
504
2658
5383
5383
8041
Commission

Agent Bill July 2011 60

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Agent Bill July 2011 60

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Dev Officer Wise Agent Bill

Time run: 8/1/2011 11:46:23 AM

162, AASHIYANA, SARJAN

Effective Start Date

Policy Expiry Date

Mr. MR, VIRAF RATAN MESSMAN .

Mr. MR, DEVANG D KHADEPAV .

Mr. MR, DEVANG D KHADEPAV .

Mr. PUSHKAR H DALAL

Mr. MR, ZARIR S KATPITIA .

Mr. MR, ZARIR S KATPITIA .

Mr. AMEE SATYENBHAI DALAL

Mr. MR, PRADEEP RATILAL NAVIK .

SUNIL SURESH DHAMANWALA

34 Health Insurance Total

46 Traditional Business - Miscellaneous

Mr. MRS.KETY C TODIWALA

Mr. ADIL M. BARIA .

Mr. DR. HOMI DARABSHAH DOODHWALA

DR. (MRS) PERSIS HOMI MEWAWALA

PARMAR MUKESH NATVARBHAI

46 Traditional Business - Miscellaneous Total

Effective Start Date

Policy Expiry Date

Mr. NILESHKUMAR SURESHCHANDRA SANKHLA . Individual

Mr. SURESHCHANDRA KHAYALILAL SANKHLA

301 ORION HOUSE B/H RESHAM BHAWAN LAL

Effective Start Date

Policy Expiry Date

Mr. ASHWIN TARACHAND ADANI -

PAWAR PRAKASH SHANTARAM.

Mr. PARMAR MEHUL DINESHBHAI -

PARMAR DINESHBHAI NATVARBHAI

34 Health Insurance Total

18, PATEL NAGAR

Effective Start Date

Policy Expiry Date

Effective Start Date

Policy Expiry Date

GOYAL VINOD SHYAMAL.

DR. KANUGA MAKSUD G.

H - 1, 1/528, RAVI PARK

Effective Start Date

Policy Expiry Date

VISHAL MAFATLAL SHAH.

MR. MAFATLAL P. SHAH.

Party License Expiry Date

Mr. MR.JITENDRA D CHAMPANERIA

Mr. PINKIBEN G. CHAUDHARI -

Mr. PARESHBHAI G. BHAKTA -

Mr. NAVINBHAI P. PATEL -

Mr. SIMRITA LAMBA -

Mr. KISHORE KUMAR SHA .

Mr. KAMLESH C PATEL

Mr. PARESHBHAI G SUTHAR .

Mr. JIGARBHAI M PATEL .

Mr. MAHESHBHAI L PATEL .

Mr. AMJADKHAN B PATHAN .

Mr. RAJU SACHDAV .M.

Mr. HIREN R PRAJAPATI .

Mr. RAMKRISHNA V. KOPPULA -

Mr. NITABEN VINODSINH VANSIYA

Mr. NARENDRA ISHWARSINH ATODARIYA

Mr. HEMENDRASINH J VANSADIYA -