Allianz insurance

21th April 2004Reference No: HRA /L10577/21042004

ALLIANZ GENERAL INSURANCE MALAYSIA BERHAD4117, Jalan Toman 6,Kemayan SquareOff Jalan Sg, Ujong70200 serembanNegeri Sembilan

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – ,PASSPORT NO: AD 735343, POLICY NO:03WSN000594

We attached herewith the following documents for your action:

1) Medical Bill = Total : RM 577.00, payable to”Windar Riwanto”. Kindly reissue the same cheque for

Your usual prompt attention in the matter is highly appreciated.

Thank you

Yours SincerelyGAH HUP SENG SDN BHD

NOORHASMAH AHMADHR & Admin ManagerHRA/lin:c2:MAA INSURANCE/2002

24th March 2004Reference No: HRA /L10152/24032004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – WINDAR RIWANTO ,PASSPORT NO: AD 735343.

1) Cheque No. 308643, RM 352.00, payable to”Windar Riwanto”. Kindly reissue the same cheque for the same amount payable to “ Gah Hup Seng Sdn Bhd”

2) Petty Cash Voucher proving that Windar Riwanto has received the amount.

3) Receipt Discharge And Indemnity

Thank you

2th January 2004Reference No: HRA /L10306/12012004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – ERWAN ,PASSPORT NO: AF 853521, POLICY NO:03WSN000462-0021

1) Medical Bill = Total : RM 261.00, payable to”Gah Hup Seng Sdn Bhd”.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – WINDAR RIWANTO ,PASSPORT NO: AD 735343, POLICY NO:03WSN000594-0005

Kindly proceed with payment of RM 352.00, payable to Windar Riwanto.

Thank you

13th August 2004Reference No: HRA /L10840/12082004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – DARKIM ,PASSPORT NO: AF942943

1) Receipt Discharge And Indemnity – Total Amount = RM 81.002) Receipt Discharge And Indemnity – Total Amount = RM 22.00

Thank you

09th July 2004Reference No: HRA /L107802/09072004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SUBANDI ,PASSPORT NO: AG076641

1) Receipt Discharge And Indemnity – Total Amount = RM 187.002) Medical Bill = Total : RM 356.00, payable to”Gah Hup Seng Sdn Bhd”.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – VONG PHEANG ,PASSPORT NO: N0128636

1) Receipt Discharge And Indemnity – Total Amount = RM 22.002) Medical Bill = Total : RM 135.00, payable to”Gah Hup Seng Sdn Bhd”.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – KASBI ,PASSPORT NO: AG 206553, POLICY NO:03WSN000671-0007

Thank you

12th August 2004 2004Reference No: HRA /L10364/12012004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SUJARWO ,PASSPORT NO: AF 942943, POLICY NO:03WSN000671-001

1) Receipt Discharge And Indemnity – Total Amount = RM 47.00

Thank you

12th February 2004Reference No: HRA /L10366/12012004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – DARKIM ,PASSPORT NO: K 791919, POLICY NO:03WSN000594-0006

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SUHARDIYANTO ,PASSPORT NO: AG 340545, POLICY NO:03WSN000712-0001

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – ERWAN ,PASSPORT NO: AF 853521

Thank you

24th August 2004

Reference No: HRA /L10780/24082004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – DARYANTO ,PASSPORT NO: AG 818890

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SUBANDI ,PASSPORT NO: AG 076641

Thank you

13th August 2004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – VONG PHEANG ,PASSPORT NO: N0128636

Thank you

15th September 2004Reference No: HRA /L11031/15092004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – WIN MYAING , PASSPORT NO: 565871

1) P.P.5 . Kindly reissue cheque for the same amount payable to “ Gah Hup Seng Sdn Bhd”

2) Petty Cash Voucher proving that Win Myaing has received the amount.

Thank you

15th September 2004Reference No: HRA /L11031/15092004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – DARYANTO , PASSPORT NO: AG 643600

Thank you

23th November 2004Reference No: HRA /L10846/12082004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – MUHROJI ,PASSPORT NO: AE 911731

Thank you

21th December 2004Reference No: HRA /L11324/21122004

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – HTEIN LYAN KYAW ,PASSPORT NO: 456405

1) P.P.5 . Kindly reissue cheque for the same amount payable to “ Gah Hup Seng Sdn Bhd”

2) Petty Cash Voucher proving that Htein Lyan Kyaw has received the amount.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SUTRISNO, PASSPORT NO: AE 124070

1) P.P.6, RM 9030.71, payable to”Sutrisno”. Kindly reissue the cheque amount RM 1000.00 payable to “ Gah Hup Seng Sdn Bhd”

1) Petty Cash Voucher proving that “Sutrisno” has received the amount.

Thank you

Attn: Ms. Lily

Dear Sirs,

2) P.P.6, RM 3050.00, payable to”Daryanto”. Kindly reissue the cheque amount RM 400.00 payable to “ Gah Hup Seng Sdn Bhd”

3) Petty Cash Voucher proving that “Daryanto” has received the amount.

3) Receipt Discharge And Indemnity, RM 420.00 payable to “ Gah Hup Seng Sdn Bhd.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – PURWANTO , PASSPORT NO: AG 837931

1) P.P.5, RM 66.00, payable to”Purwanto”.

2) Medical Bil = Total : RM 350.00 payable to “Gah Hup Seng Sdn Bhd”

Thank you

Attn: Ms. Lily

Dear Sirs,

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – PURWANTO , PASSPORT NO: AG 837931

We attached herewith the following documents for your action: 1) Receipt Discharge And Indemnity – Total Amount = RM 66.002) Receipt Discharge And Indemnity – Total Amount = RM 220.00

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – HEIN MIN KO , PASSPORT NO: 568642

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUT THEARA, PASSPORT NO: M 0128615

We attached herewith the following documents for your action: 1) Receipt Discharge And Indemnity – Total Amount = RM 187.00

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUJIONO, PASSPORT NO: AA 423664

We attached herewith the following documents for your action: 1) P.P.5, RM 231.00 payable to”Gah Hup Seng Sdn Bhd”.

2) Payslip October 2005 proving that “Mujiono” has received the amount.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUT THEARA, PASSPORT NO: M 0128615

We attached herewith the following documents for your action: 1) Medical Bill– Total Amount = RM 257.00 payable to”Gah Hup Seng Sdn Bhd”.

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SAMAN, PASSPORT NO: AJ 259977

1) Receipt Discharge And Indemnity – Total Amount = RM 11.00 2) Medical Bill– Total Amount = RM 109.00 payable to”Gah Hup Seng Sdn Bhd”.

Thank you

ALLIANZ GENERAL INSURANCE MALAYSIA BERHADNo.49, Jalan Toman 4,Kemayan SquareOff Jalan Sg, Ujong70200 serembanNegeri Sembilan

Attn: Ms. Josline

Dear Sirs,

FOREIGN WORKERS COMPENSATION –KASMUJI, PASSPORT NO: AA 221208

1) P.P.5, RM 242.00 payable to”Kasmuji”.

Thank you

Attn: Ms. Josline

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SURATAM, PASSPORT NO: AF 851024

2) P.P.5, RM 165.00 payable to”Suratam”.

Thank you

Attn: Ms. Josline

Dear Sirs,

1) P.P.5, RM 99.00 payable to”Mujiono”.

Thank you

Attn: Ms. Josline

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUHAMAD BUANG APENDIPASSPORT NO: AD 833005

2) P.P.6, RM 8506.00 payable to”Muhamad Buang Apendi”.

Thank you

Attn: Ms. Josline

Dear Sirs,

Thank you

Attn: Mr. James Chua

Dear Sirs,

1) Receipt Discharge And Indemnity – Total Amount = RM 148, payable to “Gah Hup Seng Sdn Bhd

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SURATAM, PASSPORT NO: AF 851024

1) Receipt Discharge And Indemnity – Total Amount = RM 267, payable to “Gah Hup Seng Sdn Bhd

2) Receipt Discharge And Indemnity – Total Amount = RM 165

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –KASMUJI, PASSPORT NO: AA 221208

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUHAMAD BUANG APENDIPASSPORT NO: AD 833005

1) Receipt Discharge And Indemnity – Total Amount = RM 420.00, payable to “Gah Hup Seng Sdn Bhd”

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –MUT THEARAPASSPORT NO: M 0128615

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SAMAN PASSPORT NO: AJ 259977

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SURATAM & MUJIONO

1) Payment voucher - Total Amount = 415.00

Thank you

Dear Sirs,

1) Receipt Discharge And Indemnity – Total Amount = RM , payable to “Gah Hup Seng Sdn Bhd

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –KURNIAWAN, PASSPORT NO: AA 275661

1) P.P.5 – Total Amount = RM66 , payable to Kurniawan

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –BADRUL UMAM PASSPORT NO: AA 854627

1) P.P.5 – Total Amount = RM44 , payable to Badrul Umam

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –THA WNG KHAW PALI, PASSPORT NO: 584727

1) P.P.5

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SAMAN, PASSPORT NO: AJ 259977

Thank you

13th October 2006

Dear Sirs,

FOREIGN WORKERS COMPENSATION – FATHUROHMAN, PASSPORT NO: AA 994023

1) P.P.5

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –THA WNG KHAW PALI,PASSPORT NO: 584727

1) Receipt Discharge And Indemnity – Total Amount = RM170.00 , payable to “Gah Hup Seng Sdn Bhd

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –SAMAN,PASSPORT NO: AJ 259977

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –BADRUL UMAM,PASSPORT NO: AA 854627

Thank you

Dear Sirs,

FOREIGN WORKERS COMPENSATION –BUDIYANYOPASSPORT NO: AH 395077

1) P.P.5 , Total : RM 22.00, payable to “ Budiyanto”

Thank you

AMERICAN INTERNATIONAL ASSURANCE COMPANY LIMITEDMenara AIAJln Ampang50450 Kuala Lumpur

Attn: Ms. Josephine

Dear Sirs,

MEDICAL BILL –SHARIZAM B MOHD SHARIS, IC NO : 760905-10-5029

1) Medical Bill = Total : RM 226.00, payable to”SHARIZAM B MOHD SHARIS”.

Thank you

11th August 2008

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – THUTUKO ,PASSPORT NO: AB 559685

1) Kindly reissue the cheque amount RM 704.00 payable to “ Gah Hup Seng Sdn Bhd”

2) Petty Cash Voucher proving that “Thutuko” has received the amount.

3) Medical Bill = Total : RM 1907 .00, payable to”GAH HUP SENG SDN BHD”.

Thank you

11th August 2008

Dear Sirs,

FOREIGN WORKERS COMPENSATION

Thank you

13th August 2008

Dear Sirs,

FOREIGN WORKERS COMPENSATION – MUHASIM ,PASSPORT NO: AH 395899

Thank you

13th August 2008

Dear Sirs,

FOREIGN WORKERS COMPENSATION – FATHUROHMAN ,PASSPORT NO: AA 994023

Thank you

13th August 2008

Dear Sirs,

FOREIGN WORKERS COMPENSATION – SULISTIYO PRIHANTORONOPASSPORT NO: AB 745463

Thank you

29th August 2008

Attn: Mr. James Chua,

Dear Sirs,

FOREIGN WORKERS COMPENSATION – EDI WIYONO ,PASSPORT NO: AB 879621

1) P.P5,Kindly reissue the cheque amount RM 198.00 payable to “ Edi Wiyono”

Thank you

25th February 2009

ETIQA INSURANCELevel 19 Tower CDataran MaybankNo 1 Jalan Maarof59000 Kuala Lumpur

Attn: Mr. James Chua,

Dear Sirs,

FOREIGN WORKERS COMPENSATION – LISTIAWAN ,PASSPORT NO: AK 430020

1) P.P5,Kindly reissue the cheque amount RM 495.00 payable to “ Listiawan”

Thank you

KOO MEE HARHR & Admin ManagerHRA/lin:c2:MAA INSURANCE/2002

18th March 2009

ETIQA INSURANCELot 2 D &2E Tingkat 2Wisma DPMNSJln. Dato’ Bandar Tunnggal Seremban N. Sembilan

Attn: Ms. Mei Ling,

Dear Sirs,

FOREIGN WORKERS COMPENSATION – Than Shwe ,PASSPORT NO: A 081125

1) PP6, Kindly reissue the cheque amount RM 21,147.86 payable to “ Gah Hup Seng Sdn Bhd”

2) Payment Voucher proving that “Than Shwe” has received the amount.

3) Medical Sick Leave

4) Medical report

5) Claim Form

6) Copy letter send to agent Mr. James chua 13/02/2009

Thank you

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – ,PASSPORT NO: 4415627, POLICY NO:08WSN901343

1) Pasport copy

Thank you

15th October 2010Reference No: HRA /L163251/15102010

LONPAC INSURANCE BHDLG, 6th 21 st FloorBangunan Public BankNo 6 Jln Sultan Sulaiman50000 Kuala Lumpur

Attn: Mr Denis

Dear Sirs,

FOREIGN WORKERS COMPENSATION RATNO – ,PASSPORT NO: AM 036347 ACCIDENT DATE : 09/10/2010

1) Pasport copy2) Medical Bil = RM 1977.00

Thank you

KOO MEE HARHR & Admin Manager

ETIQA INSURANCENo. 395, Jln 4/2Pusat Komersial Oakland70300 Seremban 2N.Sembilan

Attn: Ms. Mei Ling,

Dear Sirs,

FOREIGN WORKERS COMPENSATION – THAN ZAW HTWE, PASSPORT NO: A 361575

1) P.P5,Kindly reissue the cheque amount RM 835.31 payable to ”GAH HUP SENG SDN BHD”.

2) Payslip (November 2010) proving that “Than Zaw Htwe” has received the amount.

3) Medical Bil , Amount : RM 4914.6.00 payable to ”GAH HUP SENG SDN BHD”.

Thank you

28th Februari 2011Reference No: HRA /L/28022011

Attn: Ms. Lily

Dear Sirs,

FOREIGN WORKERS COMPENSATION – DIPENDRA SAH,PASSPORT NO: 4077486

Thank you

LONPAC INSURANCE BHDLG, 6th 21 st FloorBangunan Public BankNo 6 Jln Sulta n Sulaiman50000 Kuala Lumpur

Attn: Mr Denis

Dear Sirs,

FOREIGN WORKERS COMPENSATION DO VAN HOAN – ,PASSPORT NO: B3887403

1) Kindly reissue the cheque amount RM 55.00 payable to “ Gah Hup Seng Sdn Bhd”

2) Petty Cash Voucher proving that “Do Van Hoan” has received the amount.

3) Medical Bil , Amount : RM 530.00 payable to ”GAH HUP SENG SDN BHD”.

Thank you

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