BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD. CERTIFICATE CUM POLICY SCHEDULE Policy Servicing Office Policy Number Period Of Insurance
Insured Name Insured Address
Customer Id Application No
608-609, IInd Block, White House, Begumpet, Hyderabad-500016 Hyderabad-500016 PH:040-44320100/44380100, PH:040-44320100/44380100, OG-14-1801-1802-00000348 Product Two Wheeler - Package Policy Policy issued on 03-APR-2013 From: From: 24-MAR-2013 00:00 (Hrs) Cover Note No. MC1003848173 To: To: 23-MAR-2014 Midnight FIVESS POWER PROJECTS PRIVATE LIM- Zone A ITED PLOT NO: 122, ROAD NO: 23, IAS & IPS COLONY, PRASHAN NAGAR ROAD NO:22,, JUBILEE HILL HYDERABAD, HYDERABAD, HYDERABADHYDERABAD500033 33560456 Premium Payer Id 39683404 0 Scrutiny No 25364569 Policy Status ISSUED
Coinsurance Details : NA. : NA. Registration No AP02Q2946 Vehicle IDV 15958
Make TVS
Model STAR CITY
Elec. Accessories 0
SubType STD
Non-Elec. Acc. 0
CC 100
Year Of Mfg 2007
Side Car 0
Se S eat Cap 2
Chassis number. MD625KF5171A60832
Trailer Reg No -,-
CNG/LPG Unit 0
Engine No. BF5A71057412 Total Sum Insured 15958
SCHEDULE OF PREMIUM Own Damage Total Own Damage Premium
Total Premium Special Discount Net Premium Service Tax Edu Cess Final Premium Rs.
Liability 186 Basic Third Party Liability PA Cover For 2 Passanger Of Rs. 40000 each Total Act Premium: 599 0 599 72 2 Figures are in Rupees 673 *** All Premium Figures
357 56 413
Geographical Area : India : India No Claim Bonus : -35% Voluntary Excess : Nil Compulsory Deductible : Rs. : Rs. 100 Additional Compulsory Deductible : Rs. 0 Previous Insurer - Bajaj Allianz General Insurance Co Ltd. Previous Policy No - OG-12-1801-1802-00082883 Expiry On - 23-MAR-13 The above Total OD Premium is inclusive of all applicable Loading/Discounts Loading/Discounts viz (Automobile Association Membership,Voluntary Membership,Voluntary Excess,Anti-Theft,Handicap Excess,Anti-Theft,Handicap Person,Driver Tution,Fibre Glass,Cng/Lpg Unit,Geographical Extn,Imported Vehicle etc wherever applicable) LIMITS OF LIABILITY: Under section II-I(i) of the policy -> Death of or bodily injury : Such amount is necessary to meet there requirements of the Motor Vehicles Act,1988. Under section II-I(ii) of the policy -> Damage to Third Party Property : Rs. 100000
LIMITATION AS TO USE : The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal luggage), Organised racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.
DRIVER : Any person including the insured Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a licence. Provided also that the person holding an effective Learner's licence may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Past Claim Reference : IMPORTANT NOTICE : The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this schedule. Any payment made by the Company by reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause headed AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY.
Subject to IMT Endorsement Nos: 22, 18, & Policy wordings attached herewith
Broker Code 15323143 Channel Name : MD Broker Name : COASTAL INSURANCE BROKERS PVT LIMITED Contact No : 0/0 Email Premium Collection Details :- [Receipt No/Collection No/Amount] Rs. 673, By Float No : 15323143 *** If premium paid through cheque, the policy is void ab-initio in case of dishonor of cheque. This certificate of insurance is issued in accordance with the provision of Chapter X and Chapter XI of M.V.Act, 1988.
In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858 ,1800-102-5858,1800-209-5959(Toll Free) / 91-020-30305858 (chargeable, add area code before this number in case of mobile call) or email us at '
[email protected]' 25364569/-/15323143/0/MC 25364569/-/15323143/0/MC1003848173 1003848173 PIN NO : NA Damage Details: Remarks : Kindly contact our nearest / local office(s) for No Claim Bonus Confirmations. For & On Behalf of Bajaj Allianz General Insurance Company Ltd. Stamp Duty Rs. 0.25 Authorized Signatory Printed , Signed and Executed at Pune
Consolidated stamp Duty paid vide Receipt No: .8 dated 17-JAN-13 Regd Office : GE Plaza,Airport Road, Yerwada Pune-411006 (India)
Regd Regd.. Offi Office ce : GE Plaz Plaza, a, Airp Airpor ortt Road Road,, Yera Yerawa wada da,P ,Pun une e - 4110 411006 06 (Ind (India ia))
Serv Servic ice e Tax Tax Reg. Reg. No. No. AABC AABCB5 B573 730G 0G-S -STT-00 001 1 -Latest Schedule- 03-Apr-2013 15:34:59 PM (Web) Generated by uv karunasri