Beruflich Dokumente
Kultur Dokumente
A. Proposer details
1. Proposer Name : MADUGULA KRANTHI KUMAR
2. Proposer Address : H NO,5-104/1,SC COLONY, GATLANARSINGAPUR ,BHEEMADEVARAPALLY,
WARANGAL
, , WARANGAL, TELANGANA-506002
3. Proposer Mobile Number : 7893328070
4. Proposer Residential Number : NA
5. Proposer e-mail id : kranthi5520@gmail.com
6. Proposer Profession : NA
B.Vehicle Details
Registration Month / Year Vehicle Vehicle Vehicle Sub Cubic Capa- Fuel Type Year of Man- Seating Ca-
Number of Regn Make Model Type city ufacture pacity
AP36AS5279 OCT/2012 BAJAJ AVENGER STD 220 Petrol 2012 2
220
Engine Number Chassis Number Vehicle IDV (in Electrical Non-Electrical CNG/LPG Unit Total IDV (in
Rs.) Accessories Accessories (Extra fitted) Rs.)
IDV (in Rs.) IDV (in Rs.) IDV (in Rs.)
PDZCCDO4983 MD2A22EZXCC 42500 0 0 0 42500
D05037
C. Coverage opted
Authorized Signatory
GSTIN / UIN NA
STATE CODE / 36 - Telangana
NAME
Make & Mod-
Registration Number Place of Registration Engine Number Chassis Number SubType
el
BAJAJ -
MD2A22EZXCCD
AP36AS5279 WARANGAL PDZCCDO4983 AVENGER STD
05037
220
Year Of Manufactur-
NCB % CC Seating Capacity Hypothecation Details
ing
-20 220 2 2012
Limitation as to Use 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.
Driver Any person including the insured provided that a person driving holds an effective driving li-
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.
Limits of Liability 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 -> Dam-
age to Third Party Property : Rs. 100000
No Claim Bonus 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.
Existing Damage Details NA
Nominee Details Name :Na - Relationship :Na
Subject to Warranties/ 22,
IMT-Endorsements/
Add on Package
Additional Details Coinsurance Details: - . Transaction Id: -
Premium Details Receipt No. 1805-00215205, Date 22-JAN-20 ** 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
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.
Stamp
Duty Rs.
0.25
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs.0.25/- paid towards Insurance Stamps vide Challan No. MH007483221201819M Defaced No. 0004477940201819 Order No. CSD/224/2018/4914/18 or-
der dated 15-Nov-2018 defaced date dated 12-NOV-18 timing 19:55:13 of General Stamp Office,Mumbai,India.
BAGIC GST No : 36AABCB5730G1ZY | Principal Location : North East Plaza, 4th Floor, Beside BMW Showroom, Opp: RTA office,
Erramanzil X Roads, Hyderabad - 500082 PH:04033122800 | Services Accounting Code : 997134 - Motor vehicle insurance services. No
reverse charge is payable on these services.
Bajaj Allianz General Insurance Company Ltd.
1st Floor, Loyal Arcade, Subedari, Hanamkonda, WARANGAL - 506002
Contact No:Contact No: 0870-2448080,0870-2448080; Fax No: 0870-2510006
RECEIPT
Authorised Signatory