Infinity Resources, Inc.

Carrier Name - List Bill 04/2002 Location(s): All Division(s): All Subtotaled by: Division

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

Total Premium            $1,150.00

---

HTML version, Excel file would open instead.