Scribd Logo
Upload

Welcome to Scribd!

  • 6 Hr55y7638

    Uploaded by

    anshi
    6 views3 pages
    insurance

    Original Title

    6 hr55y7638

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    insurance

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    6 views3 pages

    6 Hr55y7638

    Uploaded by

    anshi
    insurance

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 3
    Questions that cad necessarily o be listed for granting the (1) mare / afer ‘freer \(), Personal Details of Proposer/Owner: Sard cover as per the Motor Vehicle Act-1988 4, meee (rife) TGR Ay Address (where the vehicle is normally kept) TJRLAW TRANS bo aisTiCS (ere a a cent 4) ‘ cae (Proposer's (Owner's) Full Name wor 110 |__(in Capital Letters) 2. War (et arr we ates wa GAT 21 ZW SVR DeviKkq Tower (Pr ats aia) ‘ Chander NaSar | Gra2iata Period of Insurance g (In Capital letters, with Pin code) Ei wrT/Phone: ISYyoogy —ft/PIN: Qotol! 3 hangs /Mobile 5.9 3. RT /Fax: I 5 £43 /E-Mail : é 3. OAR / aaa fi Occupation/Business achitamerne o Led: cow 4, TROT HT ETE “dae atea” ae Type of Cover Liability Policy Only 6. mt arate i H(i). Sea B far A(II). Vehicle Details Och Bon Are. 6. aret Hotter a Registration Number of the vehicle ares Geter Sr ater Date of Registration of the Vehicle 7 HRSSY F638 S[266 8. Cote steer ve sera safer Registering Authority & Location ‘Prater at Year of Manufacture: ~ or a. Engine Number, \Qrb63 ‘aftre a. Chassis Number ares fear Pav2344 ‘THEA HT HT (7) Make of the Vehicle Vehicle Specifications = Panne Rey lon? tee Aisa Model Pb ‘at ar TER ‘Type of Body reed. aret OY Garon are (AST) Cubic Capacity of the Vehicle (C.C) thaeoky aw National insurance Company Limited Registered Offew Address 3, Makita Svaet, Post ox No. 929, Kalina - 70007: 506-09, Kash, 25, Kestrba Gandhi arg, New Da, Dan Pins THOT Foie 014 SO0T6271(G), DOT V8RS9 Fa —_____GERTIFIGATE OF INSURANGE CUM POLICY SCHEDULE ew Poicy Prev Paley Wo: Pray Paley Year PollcyNo: 3S4301/8u6/6300001489 —fasuedon 2008/2018 ] Package (Goode Carring(Oter than Soh. Pub Carers) Collection No: 35490%88160000000064 Collection Date 080772016 INSURED DETAILS: Name! _ WS JALAN TRARSLOGISTIOS NOIALTO ‘Address: BUISNESS CENTRE NVILLAGE, KHUJURI NH, TEHSI-OMARUHERA, OISTT-REWAR| HARYANA.123106, Dist REWARL, Haryana PI Coe: 123708, Tetonone ProfesonBust Not Mentone PEROD OF WSURANGE From’ 3aWaRH16 ——TE0000 Tor midaightot awOeaOIT ‘gent Cade: a7eaviionneoet [gent anion, 007900 [esters Source Coder ibaa ‘Agent Name! Advance Life insurance Brokers PvLtd- Maln Ofc Vehicmate_[ALTSH6 uM [Seagrphical ee Engine [Chasse [Tyre [co] ve | sea | Regd | _Placoot Ne No | ef By otttis | Siuw | Number | Rogintration wade ‘areca | vzise ounce Jo [ave | vezo0 | new Nat Reaures INSURED DECLARED VALUE Power oT Bate? tateion Te Ses Tov Venide | Nan Ect eas ———T enonpo mie Taio necepzoree| socwegores eee Gal Ai © te ris © @ © Re 1.1000 Ro Op FETA in SoHEDILE oF PREMIO Row DANAE @ suas © KES SE ea Bara Sacharge NW 189) te evsore3 75004 | ee | z Mi Depreciation Premiums ° Rass I Tyee] ROSS TT i PTR = iso = 3 NOTE: WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM Servee Tar GUSH “40800 ‘CHEQUE, THIS DOCUMENT STANOS AUTOMATICALLY CANCELLED ABsNTIO Sadi sac Goce na - Tota Premium: © sse700 [Compulsory Excess: 1,000 Imposed Excass:€ 0 Voluntary Excess [Unlnion ast se ‘The Poe cover we ony order a parm wn bw moaning oe Moor Voice A989 of wah a cavage fling wnea Sobaacion 3 ‘Seeson 6 tthe Mor Vehices Act F968 The Poly eoes nl coves use ora) Oana Reino) Pass Maknge) Releotly Tess) Speed Tesing (vers Cisse: Any person clung Instr Proved ha &peron cvng hide an afc cving cence a he tine of he acer andi ot

    You might also like