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ype ADDITIONAL COLLECTION 08/07/12 JETBLUE AIRWAYS 90101ETBLUE NY 5509.80 JETBLUE AIRWAYS From: To: Carder. Class: SAN FRANCIXO INTL N.Y.1 F KENNEDY I 86 H WA YY 00 WA YY 00 WA YY 00 root Hunter. 27921801959594 Date of Depanure:08/07 Passenger Name = Document Type: PASSENGER TICKET
SHING NY 718-5141203 $6.60 07/26/12 PARADIES JFK 9212 ()JAMAICA NY 4043447905 $84.19 AMEX00035
ll pay the applicable benefit amount as determined from the Table of Losses for the benefits listed below if a Covered Person suffers a loss from an Injury white coverage is in force under the Policy. For Dismemberment the Company will pay the applicable benefit amount as determined from the Table of Lo
Class: 86 YY 00 YY 00 YY 00 Date of Departure:07/21 07/16/12 AMERICAN EXPRESS TVLPHOENIX AZ JETBLUE AIRWAYS CORPORATI From: To: N.Y.! F KENNEDY I PALM BEACH INTERNA WA WA WA Ticket Number. 27970763674313 Passenger Name: Document Type: SUPPORTED REFUND $439.80 Carrier: Class: 66 YY
ll pay the applicable benefit amount as determined from the Table of Losses for the benefits listed below if a Covered Person suffers a loss from an Injury while coverage is in force under the Policy. For Dismemberment the Company win pay the applicable benefit amount as determined from the Table of Los
1,818.32 07/10/12 PC RICHARD & SON ISNEW YORK NY -$734.87 07116/12 AMERICAN EXPRESS TVLPHOENIX AZ JETBLUE AIRWAYS CORPORAll From: To: N.Y.1 F KENNEDY I PALM BEACH INTERNA N/A N/A N/A Ticket Number: 27970763674302 Passenger Name: Document Type: SUPPORTED REFUND AMERICAN EXPRESS TVLPHOENIX A
ll pay the applicable benefit amount as determined from the Table of Losses for the benefits listed below if a Covered Person suffers a loss from an Injury while coverage is in force under the Policy. For Dismemberment the Company will pay the applicable benefit amount as determined from the Table of Lo
of Departure: 09/27 $475.70 09/26/12 AA AIR TICKET SALE 4DALLAS TX AMERICAN AIRLINES From: Tcc ST THOMAS CYRIL E MIAMI INTERNATIONA N.Y. IF KENNEDY I N/A N/A Ticket Number Passenger Name: VlSOSKVLARRY Document Type PASSENGER TICKET Carrier. AA AA YY YY Date of Departure:09/27 Class:
ll pay the applicable benefit amount as determined from the Table of Losses for the benefits listed below if a Covered Person suffers a loss from an Injury white coverage is in force under the Policy. For Dismemberment the Company will pay the applicable benefit amount as determined from the Table of Lo
Description 35P47F 1.900.65 EurapeM Euro $2.43473 05/24/12 MINTZ MANKATO MN JETBLUE AIRWAYS CORPORATI From: To: PALM BEACH INTERNA N.Y.1 F KENNEDY I N/A N/A N/A Ticket Number Passage. Name: Document Type PASSENGER TICKET Carrier: Class: B6 8 TY 00 TY 00 TY 00 Date of Departure:
ll pay the applicable benefit amount as determined from the Table of Losses for the benefits listed below if a Covered Person suffers a loss from an Injury while coverage is in force under the Policy. For Dismemberment the Company will pay the applicable benefit amount as determined from the Table of Lo
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