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13AJAJ Milan
BAJA) ALLIANZ GENERAL INSURANCE COMPANY LTD,
CERTIFICATE CUM POLICY SCHEDULE
Policy Sery icing Office s-6-126,1" Flier, Near rot' hori.n a rothirann put, rar imnagr-505COL PHD878-8450733.
Policy Number 06-12-1.810-1/00C2-00121.86 Product Two-Wheeler-Package Pa I ocio
Period Of Insurance From: 2-F EB-2011 COZOIHrsi Policy Issued m 2-F E 8-2013
To: 1- FE 8-2014 !Midnight Cover Note No.
Insured Name MRSRAVAN ruMAN BOD buLA Lone B zone
vo SAIL U, HO 816-10.147, KALYAN NAGAR.
GO DAVAR ir HAN! icaRiMNA8R-
405.2081
insued Id 320./4063. Premium Parer id 32024063
Application Na all Scrutiny No 0546777
0: Poiky tatus ISSUED
Yearof Seat
Registration No Mahe Model huh Type CC Chassis Na. Enene No.
Mfg Cap
KICK DRUM &
APBRAOT211 YAMAHA PM 153. 2011 2 ME121C0M.82031957 21{8032280
ALLOY

Total Sun
Vehicle 10V Elec. Accisscrin Non-Elec. gcc.. Side Car CNGAPG Unit
bared
4231{1 0 0 null 4231{1
SCHEEI UL E CS PPEM1Lifin

Own Damage Liability

Total Own Damage
402 Basic Tin rd Party Liability ADD
Premium
PA Cover of Owner-Driver of Rs. 10:000 50
Total Act Premium: 350
Total Premium 010
Special [amount 0

Net Premium 920

Service Tax 126
Edu Cess 5
Final Neosho's Rs. 1045 ." All rie ri loll Figures are in Rupees
Geographical Area: India No Claim Bonus. -25% Voluntary Eacms: Nil
Company Deducible; R s50 additional Compulsory Deductible! Ps.0
Previous Policy No 0O-10-1.810-1802- 3143 Expired On 26-SaN-1

The a hove Iota I OD Premium is inclusive of all applicable Loadin g}d mounts vii (Automobile Association ?Membership...Voluntary Excess, Anti-
T heft, Handicap Person, Dr ner Tuition, FHme8lass, eng Lpg Unit, Ceographical Extn, Ion ported Vehicle etc wherever applicable'.
L IM ITS Of LIAR Uri: Under section-II-101g the Policy Death of bodily injury such amount is necessary to meet there is a requirement for the Motor
Vehicle Act 14152. Under section II-I {111 of the policy-, Da mage to Third Party Property: Rs. 100002
LIMITATION AS 76 uSE: The Policy covers use of the vehicle for any purpose other than: Hire or reward, Car lage of Good (other t ha n sa m p les or
personal luggagek Organsed racing, Pace mak mg, Speed test mg, Reim b l rty tr a Ls, Arty pur pose in connection w rth Motor Trade.
DRIVER: Any person roaming the insured Provided t hat a perso n dr 11J ing holds an effect roe dr Nang licence at that pr ime time of accident and 6 not
disqual died from holding or obtaining such a licence, Provided a be that the person hokl ing a n effective Lear rierh I merice may also dnvet he vehr le a
ad that such a person sat isf es t he rem, rements of Rule 3 of the Central Motor Vehicles Rules. 1484.
Past Claim Reference:
IMPORTANT NOTICE: t he I nsured Is not indemnified if the vehicle is used for dr Nen of herwse tha n i n acoo rda rice with this schedule. Any payment
made by t he Com pa try try reason of wider terns a ppea ring int he Cert Med in order to coon ply wrth the Motor Vehicle Act, 1488 is recoverable
from the Insured. See the clause headed AVOIDANCE CIF CERTAIN TERMS AND RAFIT CIF RECOVERY.
Subject to lifir Endorsement Has: 22 &Paley wordings attached her with
Agency Code I Agency Name:
Contact No Email -