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Quoteslip Details

:
Name of the Proposer:
Registered Address:
Website address:
Who is the Proposer - Principal/ contractor/ subcontractor :
If contractor/ subcontractor then who is the Principal.
Nature of operation: [Project based/ Annual]
What is the contract period:
What is the policy period:
Since when is this client in operation:
Past claims since then:
Last Year
1 year past
2 years past
Total business from the client:
Have we offered similar type of policy to the client? If yes what has
been the claims experience !
Risk details
How many Risk locations:
List down the risk location address (s):
Exact Scope of work ? [Pls describe the work]
If construction - Pls specify CIVIL or STEEL FRAME work.
At what height will the work be:
At what depth will the work be:
Work involves blasting ?
Work involves tunnelling ?
Work involves Loading/ unloading ?
is this an Engineering risk ? If yes please detail the nature of work
invoveld.
In case of an Engineering risk. what is the final product
manufactured.
Are these Shop floor employees ?
If not "shop floor employees" what is the geographical area of
work ?
Is this an Off shore/ underwater risk ? Pls describe.
Rate:
Endorsement No:
Classification No:
Is Medical Extension required:
Per person Limit for Medical Extension:

Calculator:
DESCRIPTIO SALARY PER
N
MONTH
woker

10000

TOTAL NO.

NUMBER OF TOTAL SUM
MONTHS
INSURED

18

3

0

0

UPTO 8000

540000

432000

0

0

0

0

Excluding Blasting and Tunneling Subject to Clauses : 1) Workmen Compensation Act.000 50.000 100000 150000 200000 500000 Rate to be charged per employee Applicable WC Tariff rate x 7. 2) Fatal Accident Act 3) Comm Coverage. Exclusions. Warranted that the coverage is only in due course of employement. terms and conditions as per the standard WC policy.TAX INCL. EDU Premi Medical Extension Rates SI per employee(Rs) 25. Act. Applicable WC Tariff rate x 20 Mi Medical Extension Rates for policy less Policy Period 0 to 3 months Above 3month upto 6 months Above 6months 50% 75% Quote is subject to nil claims for the past three years This Policy excludes any interest and/or penalty imposed on the Insured on account with the requirements laid down under the W. 1923.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL N Premium after cd SER.5 Applicable WC Tariff rate x 15 Applicable WC Tariff rate x 17.C. .5 Applicable WC Tariff rate x 10 Applicable WC Tariff rate x 12. Me excluded All workers to be on wage rolls of the insured Selection of workers not allowed workers of sub contractor excluded.

00 2.988 0 27.0 - .Go to Index eslip Details: AAR AAR TRADERS 157 Calculator: ABOVE 8000 RATE %o RATE ABOVE 8000 NET PREMIUM 108000 27.0 - 0 0.0 11.25 2.25 2.

00 2.663 Extension Rates: Minimum Premium Per Employee (Rs) 100 125 150 200 250 300 for policy less than 12months: Premium 50% of *Annual ME premium 75% of *Annual ME premium 100% premium nsured on account of his/their failure to comply dent Act 3) Common Law as per the wordings.0 - 0 0.794 SER.00 2.TAX INCL.0 0.794 Add Me Net premium 5.0 - 0 0. CESS @ 14% 869.0 - TOTAL NET PREMIUM discount 11.988 52% Premium after cd 6.09 Premium Payable 6.09 5.0 - 0 0.00 2. WC policy. EDU.194.00 2. .