Common Contracts
2 similar Voluntary Medical Expenses Insurance Agreement contracts
Application-accession (Acceptance) № to the Public Agreement (Offer) voluntary medical expenses insuranceVoluntary Medical Expenses Insurance Agreement • July 9th, 2023
Place of conclusion: Kyiv Date of conclusion: This application-accession (Acceptance) is the full and unconditional consent of the Insured to enter into the Voluntary Medical Expenses Insurance Agreement(hereinafter - the "Agreement") with the PRIVATE JOINT STOCK COMPANY "EUROINS UKRAINE INSURANCE COMPANY" (hereinafter - the "Insurer") (EDRPOU code 22868348, location: 102, Velyka Vasylkivska St., Kyiv, 03150, Ukraine, account number UA033802690000026501056200817 with JSC CB "PRIVATBANK") in accordance with the procedure and on the terms and conditions specified in the Public Agreement (offer) for voluntary medical expensesinsurance (hereinafter referred to as the "Offer"). 1. INSURED (FULL NAME) Address Date of birth e-mail Passport 2. BENEFICIARY According to the current legislation 3. Subject of the Agreement The subject matter of this Contract shall be property interests that do not contradict the laws of Ukraine and are related to health and working capacity of the In
Application-accession (Acceptance) № to the Public Agreement (Offer) voluntary medical expenses insuranceVoluntary Medical Expenses Insurance Agreement • July 9th, 2023
Place of conclusion: Kyiv Date of conclusion: This application-accession (Acceptance) is the full and unconditional consent of the Insured to enter into the Voluntary Medical Expenses Insurance Agreement(hereinafter - the "Agreement") with the PRIVATE JOINT STOCK COMPANY "EUROINS UKRAINE INSURANCE COMPANY" (hereinafter - the "Insurer") (EDRPOU code 22868348, location: 102, Velyka Vasylkivska St., Kyiv, 03150, Ukraine, account number UA033802690000026501056200817 with JSC CB "PRIVATBANK") in accordance with the procedure and on the terms and conditions specified in the Public Agreement (offer) for voluntary medical expensesinsurance (hereinafter referred to as the "Offer"). 1. INSURED (FULL NAME) Address Date of birth e-mail Passport 2. BENEFICIARY According to the current legislation 3. Subject of the Agreement The subject matter of this Contract shall be property interests that do not contradict the laws of Ukraine and are related to health and working capacity of the
