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PRIVATE CAR SCHEDULE

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11

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JADUAL KERETA PERSENDIRIAN

The lnsured I Pernegang Poltsi

Policy No.

No. Polisi

JVO2238327
Account No. I No.

NUBUL HUDA BINTI ISMAIL

01-01

Akaun

8791 00-00

lype of Cover

NO 1113 TAMAN MELUR

BATANG BENAR
71700 MANTIN

Jenis Pelindungan

COMPREHENSIVE
Period of lnsurance

From I Dari 00:00:01

Occupation

Bus. Regn. No /
No Pendaftaran Perntagaan

Pekerjaan

OTHERS
LC. No.

No.Kad Pengenalar.t

Tempoh lnsurans

AM 31-07-20161o I Hingga30-07'2017

Premium I Premium

RM

All Rider I Semua Penunggang

Maximum Cumulative Loading I Tantbahan
Berganda Makstma 0.OO"k

559.80
0.00
0.00

84091 81 05730

559.80

Hire Purchase Owner

Pentilik Sewa Beli

Make & Type of Body

Buatan & Jenis Badan

PROTON SAGA BLM BLM 1.3 (MANUAL)

Regislration No. /

Excess

No.Pendaftaran

4D SEDAN

/ Lebihan

0.00

JLB1113

NIL

Tonnage / C.C./ Watt

Tan / Keupayaan Enjin

Carrying or Seating
Capacity lncl. Driver /
Muatan Tempat Duduk
Termasuk Penandu

1332.00

cc

Year of Manufacture /
Tahun Diperbuat

Regn. Card No. / No.Kad

Pendaftaran

NCD / D/skaun Tanpa Tuntutan 55.00%

31-07-2016
Wel I Berkuatkuasa dari

307.89

Gross Premium I Premtum Kasar

Service Tax I Cukai Perkhidmatan0"k
GST / GST 6% SR
Stamp Duty I Duti Setem

251.91

Acl I

Estimate of Value incl

Akta

2s1.91

0.00
15.1

10.00

RM 49.21

Accessories and Spare Parts

Nilai Anggaran termasuk
aksesori dan alalalat ganti

12,000.00

2008
Enqine/Motor No.
S4PEPE86O3

No. Enjin/Motor

T_railer I Treler
Chassis No. / No. Casts
PLl BT3SRR9BO331 26
Only The Extensions, Endorsement And / Or Warranties lndicated Below Apply To
This Policy. I Lianya Lanjutan. Endorsemen dan / atau Warranti sepeftimana yang
dinyatakan di bawah ini boleh dtguna pakai dalam polisi ini.

2, 2(t), 30, 100, 106, 87 (AGREED VALUE)

Endorsement 87 (Agreed Value) will not apply in the event any changes to the sum
insured rs made after policy inception

folal

Oue I Jumlah Berbayar

iubject to IMPORTANT NOTICE:Your duty as the Owner of the vehicle as altached. Total Due (OfC) I Jumlah Berbayar Di Kaunter
Authorised Driver I Pemandu yang Diberi Kuasa:

RM
RM

277.02
277.00

THE POLICYHOLDER, ISMAIL BIN MOKHTAR

Geographical Area : Malaysia , Republic o{ Singapore and Negara Brunei Darussalarn. I Kawasan Geografi : Malaysia, Republik Singapura dan
N egara B ru nei D aru ssal am.
Limitations as 10 Use / Authorised Driver : As described in the Certi{icate of lnsurance, I Had Penggunaan / Pemandu Yang Diberi Kuasa: Sepefti
vane tercatat dalam Sitil lnsurans.
Replacing Cover Note No./
lor I untuk
lssued By Dikeluarkan Oleh :
Gantian No. Nata
AmGeneral lnsurance
AGENCY
AL
FAHMIE
Perlindungan
7
SRI
SARAWAK
15
NO
JALAN
Renewal ol Policy No./
v6558561
TAMAN SRI ANDALAS
Pembaharuan No.Polisi
41200 KELANG
Date ol Proposal or
27-07-2016
Tel : 00333241203
Deciaration /
Fax:00333241202
Tarlkh Cadangan atau
Pengisytiharan

Date of lssue / Time

27 -07 -20'l 6 1 0:07:35 AM
Tarikh Dikeluarkan i Waktu
pt etnium yang diAenakan aclalah
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prcmium minima.

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