Payment Claims Voucher

Pcv No 2026-06-032941 Settle Date June 11, 2026
Insured Name MENGLY J. QUACH EDUCATION PLC. Policy No PA/PPI/C-48471
Claims No CL/PA/PPI/3972-01
No Invoice No Description Exchange Rate Amount
1Payment For: ACCIDENTAL MEDICAL EXPENSEUSD 432.31
Pay To: Vanna Dary/Mao Ravuth
Payment Status: Full Payment
Cheque No:
Total USD 432.31
Amount in Word USD Four Hundred Thirty Two and Thirty One Cents Only
Reviewed & Appr. PPI Signature Name Date
PREPARED BY vichet June 11, 2026
CHECKED BY AM KUSORL June 11, 2026
VERIFIED BY HOD SOCHEAN June 11, 2026
APPR BY PPI CEO SALY SOULEVANN June 11, 2026
Review And Approved By Group : CHAIRMAN & CEO CFO
Account Code Account Name Debit Credit
111006Claim Paid - PA432.31
660020Amount due from/(TO)Reinsuranc345.85
115506Claim Rec.Cam.Re- P.A86.46
114006Claim Rec.Q.T Share- P.A259.39
660215FTB-Claims Acc.432.31
TOTAL 778.16778.16