Infinity Resources, Inc.

Carrier Name - List Bill 04/2002 Location(s): Montreal - Quebec Division(s): Sales - Marketing Subtotaled by: Plan

HMO Policy Number 89343 Name SSN Division Location Effective Date Coverage Volume Premium Edwards, Andrew 123-456-789 Marketing Quebec 04/12/2002 Family   $475.59 Gallagher, Susan 987-456-123 Marketing Montreal 04/12/2002 Employee   $182.03 Jackson, Melissa 234-567-890 Sales Montreal 04/12/2002 Family   $490.90 HMO Total   $1,150.00 PPO Policy Number 349343 Name SSN Division Location Effective Date Coverage   Premium Edwards, Andrew 123-456-789 Marketing Quebec 04/12/2002 Family   $475.59 Gallagher, Susan 987-456-123 Marketing Montreal 04/12/2002 Employee   $182.03 Jackson, Melissa 234-567-890 Sales Montreal 04/12/2002 Family   $490.90 PPO Total   $1,150.00

Total Premium            $1,150.00

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