Sportsman Endorsement Advice

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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: UM-0011 Client Pin: A000145322Z

Account No B-CR01 - CROWNSCOPE INSURANCE Premium KSH.


BROKERS LIMITED
Extra Premium
The Insured UMESH KUMAR K. RAIKUNDALIA Premium 0.00
Address P.O Box 10194 - 00100 NAIROBI T/Levy 0.00
P.H.C Fund 0.00
Total 0.00
Endorsement/Renewal 05/125/6253/2022
No.
Policy No. 01/01/125/0154/2019
Period of Insurance From: 01/07/2022 } Both Dates

To: 30/06/2023 } Inclusive

PARTICULARS OF RISK
Location Of Risk Perils Covered Total Sum Insured (KSH)
AS PER POLICY Sportsman's 95,000.00

It is hereby declared and agreed that the postal address should read as 10194-00400 and not as earlier
captured in the within mentioned policy schedule.

(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..................................

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