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Descrição: Kenny Wheeler - Foxy Trot. Lead sheet pdf
Kenny wheeler songsDescripción completa
Kenny Wheeler - Foxy Trot. Lead sheet pdfDescription complète
ANNEXURE C – C – TWO WHEELER Report should be on Survey Company’s letterhead name and address . Based on the information given the following vehicle proposed for insurance has been physically inspected on…/…/….. ……………………AM / PM, at __________________, belonging to Mr./Ms./M/s. ________________________________
VEHICLE NO.:___________________ CHASSIS NO.:____________________ MANUFACTURING YEAR: __________________ ODOMETER READING _______________ INSURANCE POLICY CHECKED YES/NO BREAK PERIOD – PERIOD – MONTHS (LESS THAN 1) (MORE THAN 6)
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FRONT HEADLIGHT FRONT LEFT INDICATOR FRONT RIGHT INDICATOR FUEL TANK
INTACT/BROKEN INTACT/BROKEN INTACT/BROKEN
FRONT GUARD SIDE GUARD TAIL LIGHT TAIL LEFT INDICATOR TAIL RIGHT INDICATOR SILENCER TYRES FRONT TYRE MUD GUARD REAR TYRE MUD GUARD HORN SIDE STAND MAIN STAND FRONT FOOT GUARD (L & R) REAR FOOT GUARD (L & R) SPEEDOMETER INSTRUMENT CONSOLE COLOUR OF VEHICLE
Page - 1 - of 2
MAKE/MODEL: ____________________ ENGINE NO.: _____________________ FUEL TYPE _______________________ RC COPY CHECKED YES/NO BREAK ININSURANCE YES/NO (MORE THAN 3) (MORE THAN 1 YEAR)
We confirm the observations cited above are in respect of physical inspection of the vehicle. RECOMMANDED FOR INSURANCE
YES/ NO
“It is hereby declared and agreed that all pre existing damages to the vehicle that has occurred prior to commencement of cover are excluded from the scope of the policy”. I confirm the observations cited above in respect of my vehicle.
_____________________ Signature of Customer
______________________ Signature of Inspecting Officer
______________________ (Counter Sign SM/BM)
Note: - Employee Name & ID to be mentioned, if done by employee; Counter sign by SM/BM if done by CSO.
