Agency : ITRA

Contract n° : 4433
Booking n° : 08663_4142946
File n° : 206443
Saler ref : 10727
Saler name : WEBSERVICE . I
www.assurinco.fr 05 34 45 31 51

Booking : ITRA Annuel

Your program
Trip booking date : 22/09/2023
Subscription date : 22/09/2023
From : 22/09/2023
To : 22/09/2024
Insure Firstname and Name : Garcia Rodriguez Jorge Manuel
Avda de Coimbra 16, Bajo Derecha
Insure Adress :
15704 Santiago de Compostela (A Coruña, España)

Trip type : Forfait

Travel operator : ITRA
Destination : Several annual destinations (Unknown)

In case of
emergency persons :
Insure information :
Trip information :
Contact 1 :
Contact 2 :
Your insurance
Warranty cover : Assistance Rapatriement Annuel
Option : ---
Discount : ---
Insure name Travel Price Insurance Price
Garcia Rodriguez Jorge Manuel 0,00€ 49,00€
Traveler number: 1
Insurance : 49,00€ TTC

By subscribing, you acknowledge that you have read and accept the general terms and conditions of the contract
ITRA Annuel n° 4433.

SANCTIONS APPLICABLE IN CASE OF FALSE STATEMENT OF SUBSCRIPTION :

Any reticence or false declaration, any omission or inaccuracy in the declaration of the risk is sanctioned in the
conditions stipulated by the articles L113.8 et L113.9 of the Insurance Code :
- In case of bad faith on your part : by the nullity of the contract
- If your bad faith is not establishede : By a reduction of the indemnity in proportion to the premium paid in relation
to the premium which would have been due if the risk had been completely and accurately stated.

Date: Insure sign

ASSURINCO ASSURANCE VOYAGE - Filiale du Cabinet Chaubet Courtage

SARL de courtage en assurances au capital de 140 750 €
Siège social : 122 Bis, Quai de Tounis, 31000 TOULOUSE - Tel : 05.34.45.04.00 / RCS TOULOUSE N° SIREN 385 154 620
Immatriculé à l'ORIAS dans la catégorie courtier d’assurance sous le N°07001894 site web ORIAS : www.orias.fr
Responsabilité Civiles Professionnelle & Garantie Financière conformes aux articles L512-6 et L512-7 du Code des assurances
Sous le contrôle de l'ACPR, 4 place de Budapest - 75009 PARIS (www.acpr.banque-france.fr)
Réclamation : Cabinet Chaubet Courtage/Service réclamation : reclamation@assurinco.com / Médiation : (seulement si échec de la réclamation) :
La Médiation de l’Assurance, Pole CSCA, TSA 50110 75441 Paris cedex 9 ou le.mediateur@mediation-assurance.org