BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED

(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of India [IRDA] vide Reg No.113)
Regd. Office: GE Plaza, Airport Road, Yerwada,Pune-411006(India)

Certificate of Insurance (Two Wheeler Package Policy)

Policy Number: OG-16-1302-1802-00008911

Customer ID: 72699885

Particulars of Vehicle Insured:

Registration Number

Place of Registration

Engine Number

Chassis Number

Make & Model

UP78BU2412

KANPUR URBAN

L89347

L91407

BAJAJ - PULSAR 150

Sub Type

Year of Manufacturing

NCB %

CC

Seating Capacity

Final Premium

ELECTRIC START

2009

150

Rs.1053.

Name of Registration Authority

Name and Address of Insured

Geographical Area
Business or Profession

: KANPUR URBAN
: DUSHYANT BHATNAGAR
: 18/13 PANKI POWER HOUSE COLONY, KANPUR, ,
KANPUR, UTTAR PRADESH-208001
: India,000
: NA

Effective date of commencement of Insurance for the purpose of act:

Policy Inception Date: From 03:28 O' Clock on 13-NOV-2015
Policy Expiry Date: Midnight on 12-NOV-2016
Persons or Class of Persons entitled to drive:
Any person including the insured:
a) Provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining
such a license.
b) Provided also that the person holding an effective learner's license may also drive the vehicle and that such a person satisfies the
requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limitations as to Use:
The Policy covers use for any purpose other than
a) Hire or Reward, b) Carriage of goods (other than samples or personal luggage), c) Organized racing, d) Pace Making, e) Speed testing,
f) Reliability Trials, g) Any purpose in connection with Motor Trade
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.
Full address of Issuing Office :
11/9, SILVER LINE,, OPP. ELGIN MILLS RETAIL SHOP,, CIVIL LINES, ,, Kanpur-208001 PH:0512-2530780/81
Date of issue :13-NOV-2015
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.

For help and more information:

Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, 1800-22-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call)
Email us at customercare@bajajallianz.co.in or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 13-Nov-2015 16:41:15 PM- jayant shukla01 (Web) (NA)




BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED

(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of India [IRDA] vide Reg No.113)
Regd. Office: GE Plaza, Airport Road, Yerwada,Pune-411006(India)

TWO WHEELER PACKAGE POLICY SCHEDULE

Policy Issuing Office

11/9, SILVER LINE,, OPP. ELGIN MILLS RETAIL SHOP,, CIVIL LINES, ,, Kanpur-208001 PH:0512-2530780/81
INSURED DETAILS

Insured Name

POLICY DETAILS

DUSHYANT BHATNAGAR

Policy Number

OG-16-1302-1802-00008911

18/13 PANKI POWER HOUSE COLONY, KANPUR, ,

KANPUR, UTTAR PRADESH-208001

Policy Issued on

13-NOV-2015 16:38 PM
From : 13-NOV-2015 03:28 (Hrs)

Insured Address
Period of Insurance

To : 12-NOV-2016 Midnight

Geographical Area

India,000

Cover Note Details

Customer ID

72699885

Previous Policy No

222104/31/2015/1361

Registration Number

Place of Registration

Engine Number

Chassis Number

UP78BU2412

KANPUR URBAN

L89347

L91407

Seating Capacity
2

Year Of Manufacturing
2009

Vehicle IDV

Value For Side Car

Non electrical accessories

23820

NCB %
0

CC
150

Own Damage Premium(Rs.)

Own Damage Premium
Special Discount
Total OD Premium - A
Total Premium (Net Premium) (A+B)
Service Tax
Education Cess
Final Premium ( Rupees One Thousand Fifty Three Only )

Make & Model

BAJAJ - PULSAR
150

SubType
ELECTRIC START

Hypothecation Details

Electrical/Electronic
accessories
0

Value of CNG/LPG
kit
0

Total Value
23820

Liability Premium(Rs.)
336 Basic Third Party Liability
0 PA Cover for Owner-Driver
336 Total Act Premium - B
924
129
0

538
50
588

1053

**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)

Broker 10040880/Investacc
Code& Brokers Pvt Ltd
Name
Limitation as to Use

Driver

Limits of Liability

No Claim Bonus

Existing Damage Details

Insurance Contact No.

00000000000/00000000000

E-Mail ID.

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 license 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 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 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.
NA

Subject to Warranties/
IMT-Endorsements/Add on
Package

22

Additional Details

Coinsurance Details: - NA. Transaction Id: -

Premium Details

Receipt No. 1302-00236151, Date 13-NOV-15 ** If Premium paid through Cheque, the Policy is void ab-initio in case of dishonour of
Cheque.

Excess Details

Compulsory Excess: Rs.100

ADDITIONAL EXCESS: Rs. 0

VOLUNTARY EXCESS: Rs.0

For help and more information:

Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, 1800-22-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call)
Email us at customercare@bajajallianz.co.in or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 13-Nov-2015 16:41:15 PM- jayant shukla01 (Web) (NA)



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.

For & On Behalf of

Bajaj Allianz General Insurance Company Ltd.

Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated stamp Duty paid vide Receipt No: .29 dated 23-OCT-15
Service Tax Reg. No. AABCB5730G-ST-001

For help and more information:

Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, 1800-22-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call)
Email us at customercare@bajajallianz.co.in or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 13-Nov-2015 16:41:15 PM- jayant shukla01 (Web) (NA)