Beruflich Dokumente
Kultur Dokumente
LTD
Issuing Office :
Ph: 41519720-24
Fax: 011-41519725
Insured's Name :
Policy No.
Address :
Date Of Issuance
KULBHUSHAN ..
H.NO 73 HARKESH NAGAR , TILPAT FARIDBAD
,
FARIDABAD
HARYANA
PinCode : 121003
Phone Number : 9250582833
C/ N No : 40181625
AgentNo : 20000425
: 71660013
: 23/01/2010
20A
hrs on
: 09/11/2009
: 08/11/2010
Year of
Manuf.
UP51AD1753
2008
Type of Body
SOLO
Make of Vehicle
CC
Coverage
100
Comprehensive
Engine No.
IDV in Rs
14134
Seating
Capacity
Chassis No.
34000
01168
Registration Authority
Insured Declared Values (Rs)
Side Car
Two Wheeler
34000
Accessories
A. Own Damage
Elec./Elec. Acc.
Total Value
34000
Amount Rs.
B.Third Party
569.84 Basic Premium
- Bi Fuel Kit (IMT 25)
- PA Owner:Driver CSI Rs 100000
Basic Premium
Electrical/Electronic Accessories (IMT 24)
Accessories(IMT 33)
Bi Fuel Kit (IMT 25)
Add:
Rallies (IMT 31)
Foreign Vehicle Loading (IMT 19)
Geographical Area Extn (IMT 1)
714.70
Amount Rs.
300.00
50.00
Add:
Less:
Voluntary Express Less 0% (IMT 22A)
Side Car Discount
Anti Theft Device (IMT 10)
Automobile Association (IMT 8)
Handicap Discount (IMT 12)
Vehicle Use (IMT 13)
No Claim Bonus 20.00 %
113.97
91.17
364.70
Bi-Fuel Kit
Name
Type
100000
Any Other Loading/Discount
Net (B)
Total Preminum
Service Tax
350.00
714.70
73.61
Premium Paid
788
Under Section II-I (i) - Such amount as is necessary to meet the requirement of the Motor
Vehicle Act, 1988.
Under Section II-I (ii) - As per premium computation table
Under Section III PA Owner - Driver as per premium computation table
Deductible under section I (Rs) for Partial Loss,for Total Loss 50
No Claim Bonus will only be allowed, provided the policy is renewed within 90 days of the expiry of the previous policy.
I/we hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance
are issued in accordance with the provisions of Chapter X and Chapter XI of M.V.Act .1988.
Tie Up No : 20000139
Call Centre : 1800-103-5499 (Toll Free); ( 0124) 428-5499 ; SMS No : 56161
Service Tax No : D-III/ST/R-IV/GEN INS/01/03
KULBHUSHAN .. ..
TILPAT FARIDBAD
Authorized Signatory
deo510@itgi.co.in
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