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Renewal Notice #2

Renewal No
Code
Policy No
Expiry Date

Mohammad Shoaib Danish


P.O.Box.: 412, Jubail 31951

: 4740706
: 3620972/148723 - MR
: 43/12200198/TP
: 12/02/2015

We would like to remind you that your Motor Vehicle(s) Insurance policy will expire as mentioned above, beyond which date
Tawuniya's liability will cease to attach.
Make &
Model of Vehicle(s)

Plate No(s).

Mercury-Mountaineer

Declared Values of
Vehicle(s) & Accessories
as expiring (SR.)

6530

Excess /
Deductible
(SR.)

Renewal
Contribution
(SR.)

Admin Fee
(SR)

Total
(SR)

625

25

650

Please Read Carefully


1. Assuming there are no changes in the risk or the declared values and provided no losses or claims between the date of this
notice and the expiry date, the renewal contribution will be as detailed above.
2. To ensure uninterrupted insurance protection, kindly issue your renewal instructions by completing the lower section of this
notice and returning it to Tawuniya duly signed before the expiry date shown above. If any alterations are required regarding
cover, conditions and/or the declared values please indicate the same in the space provided below. Any such alterations may
result in revised contribution.
3. Please note that should your renewal instructions be received by Tawuniya after the expiry date shown above, a fresh proposal
form will have to be completed by you , a new policy will then be issued as of the date of Tawuniya's acceptance of the new
proposal.
4. You can return this notice after completing the lower part by fax No:01-4881719 (if payment is by credit card or bank deposit) or
by mail (if cheque is enclosed) or through SADAD system to customer service center, or you can visit the nearest Tawuniya branch.
5.The company shall not be liable in respect of any liability or expenses caused by or arising whilst the insured exceeding the
red traffic signal by the Insured or the authorized driver or drive the motor vehicle in the contrary direction .
6. Renewal will not be carried out until contribution payment is received.
7. Excluding cover whilst the vehicle is being driven by any driver under 21 years of age. Cover can be extended to include drivers
under 21 years with additional contribution as applicable.
For any clarification, please call the toll free number 920019990.

Please tick as desired

To be completed by the insured & returned to Tawuniya


Policy No: 12200198
Expiry Date: 12/02/2015

I/We wish to renew my/our policy unaltered.


(Please note that it is important that the declared value of your vehicle(s) represents the current market value(s) )

I/We wish to renew my/our Policy adding the flood and hail extension .
I/We wish to renew my/our policy with the alterations shown below.
(kindly call the toll free number 920019990 for the new contribution)

Payment Methods:
As per the above, I authorize Tawuniya, to charge me the cost of renewal of this policy, by the following payment method:
SADAD service through most banks ( Biller Code 003 ).
By Credit Card as per following details:
Visa

Master Card

Expiry Date

Card No.

Attached please find Cheque No. _________________ for SR.__________________


I/We don't wish to renew my/our policy (please indicate reason(s) in the space below.)

Month

Year

Alterations / Non Renewal Reasons : _______________________________________________________

Name : ________________________________________
Signature :_________________
Date :
/ /
Telephone Office : ________________ Home : ________________ Fax : ________________ Mobile :________________
Printed by: EBNET - Printed Date: 10/02/2015