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a @ BAJA4|Allianz@ w @BAJAJ|Allianz@ MU BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD. CERTIFICATE CUM POLICY SCHEDULE ey Serdcing Oftes S508, ey sre Kate bang, Poorman High oad, nnbokka., Choma: 600105 Poley Number (06-14-1506-1672 00000082 “Two Wooler Package Py Peso Ot neurance From: 174FE8.2014 0000 (Hs) s7EB2014 Tor 1eFEB-2018 Manone Insured Name TEHERIKAKOLLA ‘ Incured Adress NO. g20,28910,eHAGvA Naga, BGR ERR P ABR, SRDRAN PRADESH 500072 customer ‘eaorat4 Premium Payerié 40007314 ‘ppiation No ° Serutiny No aorta Petey Sta IssueD coinsurance Detlle a. [esistaton No] Wake ‘sel | subtype [Co] Vear of wig [Seat Can Trine Ws. | Aan | FOVAL EN THUNDER SHOWIN GpAnCES ow [073 z SSCODIZZEST Wericie IV [lee Aesonsoien| — Won Eee. Ace Sas tr ‘Taller ego | CNGILPG Unt | Total Suminsurea OEE T 7 ° ° TERE “SCHEDULE OF PREMTUM ‘Own Damage Tay — | oar Owsbanags Premium | 5 [Base Tra Pay CY a PR Cover or Onna Over oR TOOT o _ Fatt Ret Peru a Spaced Oscar 2 Ret Premio at Sone Tar 2a Final Premio RE THRE] At Premium Figues rein Rupes ‘Geographieal Area aia Te Glam Bonus 20% Voluntary Excess Nr ‘Compulsory Ooduetbie Rs. 100 ‘Adational Compulsory Dadvetibe: As 0 Prosar Eaay Alans Geer! Insurance Co Lis Previous Ply No -OG-181801-182.00080436 pry On -1-FEB. 14 ‘The store Teal OD Prema i nv of al appcable LoadngQiscouts viz (Automabl Associaton Mambershi Voluntary Excess Are-ThetHandeap Per son dre Tutlon ibe Glas. Cnot.pg Unt Geographical Exh mpored Veh ete werever appizabe) LIMITS OF LIABILITY: ier ston A) of pot > Det of ely ry Sih aunt i rece 1 met herent of te Maso Veickes e198, Un ‘Stoo he poly > Danae to Tt Pay Proper 1000 Lawrarion 3 70 USE he cy ne oe i fr ay aa i hn, cen Cae fea ae nl nee Ont AER: ny po ig eid Pe ter vn ol mci ving mn th ie of re a gafed o Past Clam Reernce IMPORTANT NOTICE: The Ine indi he eh ea en rae haan wh hi chee, Aye ade yh Comyn (er essai nt ert oi comply wah the Mao Vose hc Tosh hecoarbe fom h ared Sere Cat Hened AVOIDANCE OF CERTAIN Teh AND Richt OF RECOVERY Subject to MT Endorsement Nos: 22 & Policy wordings attached herewith (Broker Code 10035203 Channel Name ML 77 77772 57 KOTITR [Broker Name : S AND R INSURANCE BROKERS PRIVATE LeetrreD PRIVATE 11 Contact No: 0/0 Email - 71.4 Shr lolde (a QEA Sail cam VE(BEY PLEA, Prem Galecion as = [Recep NovGataaon Navara 10101100505 520722) PSB, proniom ad ugh chagu, the poy is od abso in cae of shana’ ol chp “Tis caiicale of wsurance issued in accordance wit he provision of Chaps X and Capte XI of MLVACt, 1988 Sh SBBSABE Aus a a, $8 aS.°05 de wear il RmberIn Case of mobo eal} oremall sn ‘customeroareabujsalians.cois Bruno Damage De: BAIA kinaly contact our nearest/ local fies) or No Clim Bonus Contimstions Fork On esto ao le Gener! isurane Company Pata, Siradand Eset Pe ta ne EES aie sap Oty pd ie Reco Ne: ts o2HI ire 0 Service Tax Reg, No. AABCBS70G-ST-001 Lajos Schedule-17-F20-2014 16-4136 PM (Web) ‘Generated by ma ghouse Rega Oi GE Plaza, Aor Road, Yerawace,Pu

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