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    Star City

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    Ajai K
    This document is an insurance certificate and policy schedule issued by Bajaj Allianz General Insurance Company Ltd. for a two-wheeler vehicle. It provides details of the policy holder such as name, address, vehicle details including make, model, registration number, IDV, and engine/chassis numbers. It specifies the policy period, premium amounts for own damage and liability coverage, applicable discounts and taxes. It also lists limitations of use, drivers covered, and contact details in case of any claims.

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    Star City

    Uploaded by

    Ajai K
    980 views1 page
    This document is an insurance certificate and policy schedule issued by Bajaj Allianz General Insurance Company Ltd. for a two-wheeler vehicle. It provides details of the policy holder such as name, address, vehicle details including make, model, registration number, IDV, and engine/chassis numbers. It specifies the policy period, premium amounts for own damage and liability coverage, applicable discounts and taxes. It also lists limitations of use, drivers covered, and contact details in case of any claims.

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    This document is an insurance certificate and policy schedule issued by Bajaj Allianz General Insurance Company Ltd. for a two-wheeler vehicle. It provides details of the policy holder such as name, address, vehicle details including make, model, registration number, IDV, and engine/chassis numbers. It specifies the policy period, premium amounts for own damage and liability coverage, applicable discounts and taxes. It also lists limitations of use, drivers covered, and contact details in case of any claims.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    980 views1 page

    Star City

    Uploaded by

    Ajai K
    This document is an insurance certificate and policy schedule issued by Bajaj Allianz General Insurance Company Ltd. for a two-wheeler vehicle. It provides details of the policy holder such as name, address, vehicle details including make, model, registration number, IDV, and engine/chassis numbers. It specifies the policy period, premium amounts for own damage and liability coverage, applicable discounts and taxes. It also lists limitations of use, drivers covered, and contact details in case of any claims.

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    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 PH:040-44320100/44380100,


    OG-14-1801-1802-00000348
    Product
    Two Wheeler - Package Policy
    Policy issued on
    03-APR-2013
    From: 24-MAR-2013 00:00 (Hrs)
    Cover Note No.
    MC1003848173
    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, HYDERABAD500033
    33560456
    Premium Payer Id
    39683404
    0
    Scrutiny No
    25364569
    Policy Status
    ISSUED

    Coinsurance Details : NA.


    Registration No
    AP02Q2946
    Vehicle IDV
    15958

    Make
    TVS

    Model
    STAR CITY

    Elec. Accessories
    0

    SubType
    STD

    Non-Elec. Acc.
    0

    CC
    100
    Side Car
    0

    Year Of Mfg
    2007

    Seat 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
    673 *** All Premium Figures are in Rupees

    357
    56
    413

    Geographical Area : India


    No Claim Bonus : -35%
    Voluntary Excess : Nil
    Compulsory Deductible : 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 viz (Automobile Association Membership,Voluntary 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 'customercare@bajajallianz.co.in'
    25364569/-/15323143/0/MC1003848173
    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. Office : GE Plaza, Airport Road, Yerawada,Pune - 411006 (India)

    Service Tax Reg. No. AABCB5730G-ST-001


    -Latest Schedule- 03-Apr-2013 15:34:59 PM (Web)
    Generated by uv karunasri

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