Page I of 9

UNITED INDIA INSURANCE CO P L ITED

SRI !VAS TA ES CO PLEX
DHAR AD - 58 001 KAR
PH : (0836 ) 2444790 FAX:

MOTORCYCLE / SCOOTER
PACKAGE POLICY
POLICY N0.:2407013114P104606602
VEHICLE NO.:KA - 25 - EN - 3044

PERIOD OF I SURANCE
From 00 :00 Hrs of 23/ 09/ 2015
To Midnight of 22/09/ 2016
J
Insured
MRS SHAKUNTALA .K.G.
W/O. ANI L. PATIL. AMAR KUNJ, NARAYANA PUR,IST MAIN, 3RD CROSS,
DHARWAD . TALUK : DHARWAD.
580008
DHARWAD
KARNATAKA

Agent Name :PREETHI SHETTY

Agent Code : AGl003 I 755
Mobile/Landline
:9999999999
Number

REGO. & HEAD OFFICE, 24 , WHITES ROAD , CHENNAI - 600014

Website : http://www .uiic.co.in, Ematl - info@u1ic .co.in
Pnnted By : TER23539 @ 22/09/20 14 11:12: 20 A M

htt p ://gccore.u i ic.i n/Con figurator/Und erwnttingMasters/reports/frm Pol icySchedul e_XA P... 20/09/20 14