Professional Documents
Culture Documents
Geographical Area
Business or Profession
Engine Number
05844
Year of Mfg
2016
NCB %
0
Chassis Number
58786
CC
150
: MUMBAI
: YASHWANT MADAGE
: B P T RAILWAY LINE GATE NO 4 KIDWAI ROAD,
NEAR JAI MANGAL SOCIETY WADALA MUM, B
P T COLONY, , MUMBAI, MAHARASHTRA-400037
: India
: NA
Authorized Signatory
Bajaj Allianz General Insurance Co Ltd., 603,6th Floor, A Wing, BSEL Tech Park,, Plot no.39/5 &
39/5A, Sector- 30 A,Opp. Vashi Railway Station, Vashi, THANE-400703 PH:022-66809500
INSURED DETAILS
Insured Name
Insured
Address
Geographical
Area
Customer ID
POLICY DETAILS
YASHWANT MADAGE
B P T RAILWAY LINE GATE NO 4
KIDWAI ROAD, NEAR JAI MANGAL
SOCIETY WADALA MUM, B P T
COLONY , , MUMBAI, MAHARASHTRA-400037
India
82869174
Bank Reference
No 1
OG-17-3067-1802-00000195
Policy Issued
on
11-AUG-2016 13:51 PM
From : 11-AUG-2016 (Hrs)
Period of
Insurance
To : 10-AUG-2017 Midnight
Cover Note
Details
0/
Previous
Policy No
Engine Number
Chassis Number
SubType
MUMBAI
05844
58786
HONDA UNICORN
SELF DISC
ALLOY
Policy Number
NCB %
CC
Seating Capacity
Year Of Manufacturing
Hypothecation Details
150
2016
Non electrical
accessories
Vehicle IDV
60846
0
Own Damage Premium(Rs.)
Own Damage Premium
Special Discount
Total OD Premium - A
Total Premium (Net Premium) (A+B)
Service Tax
Swachh Bharat Cess
Krishi Kalyan Cess
Final Premium ( Rupees One Thousand Three Hundred
Sixty Six Only )
0
0
Liability Premium(Rs.)
519 Basic Third Party Liability
0 PA Cover for Owner-Driver
519 Total Act Premium - B
1188
166
6
6
1366
60846
619
50
669
**Note: The above Total OD Premium is inclusive of all applicable Loading /Discounts viz (Automobile association membership, Voluntary Excess,
Anti Theft, Handicap Person, Driver Tuition, Fiber Glass, CNG/LPG Unit, Geographical Extension, Imported Vehicle Etc. wherever Applicable)
Agency Code
BAG100000697
Contact No.
09773665231/09773665231
Agency Name
E-Mail ID.
NARINGREKARDURGESH@GMAIL.COM
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.
Any person including the insured provided that a person driving holds an effective driving liDriver
cense at the time of the accident and is not disqualified from holding or obtaining such a license.
Provided also that the person holding an effective Learner's license may also drive the vehicle
when not used for the transport of goods/passengers at the time of the accident and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Under section II-I(i) of the policy -> Death of or bodily injury : Such amount is necessary to meet
Limits of Liability
there requirements of the Motor Vehicles Act,1988. Under section II-I(ii) of the policy -> Damage to Third Party Property : Rs. 100000
The insured is entitled for a No Claim Bonus (NCB) on the Own Damage section of the policy, if
No Claim Bonus
no claim is made or pending during the preceding year (s), as per the following: 1. The preceding
year: 20% , 2. Preceding Two consecutive years: 25% , 3. Preceding Three consecutive years:
35%, 4. Preceding Four consecutive years: 45% , 5. Preceding Five consecutive years: 50% No
Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry
date of the previous policy.
Existing Damage Details NA
Subject to Warranties/ 22,7
IMT-Endorsements/
Add on Package
Coinsurance Details: - NA. Transaction Id: Additional Details
Receipt No. 3067-00000956, Date 11-AUG-16 ** If Premium paid through Cheque, the Policy is
Premium Details
void ab-initio in case of dishonour of Cheque.
Compulsory Excess: Rs.100
Additional Excess: Rs.0
Voluntary Excess: Rs.0
Excess Details
Limitation as to Use
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.
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated stamp Duty paid vide Receipt No: .35 dated 20-JUN-16
Service Tax Reg. No. AABCB5730G-ST-001
RECEIPT
Receipt Number
3067-00000956
Receipt Date
11/08/2016
Business Channel
ML
YASHWANT MADAGE
(Customer ID : 82869174 ) a total sum of Rupees One Thousand Three Hundred Sixty Six Only by,
Instrument
Type
Online Payment
Inst./Ref No
1119840
Instrument
Date
11/08/2016
Bank Name
Branch Name
Amount
1,366
Total Amount
Rs.
1,366.00
Issuance of this receipt does not amount to acceptance of the risk by Bajaj Allianz General Insurance Company
Limited. The insurance cover for the risk shall be as per the terms and conditions of the Insurance Policy if and
when issued.
* Cheque/DD/PO receipt is valid subject to realisation of the instrument.
Authorised Signatory