LIGHT VEHICLE DATA for INSURANCE

Date of Birth (ETA Register Plate

No. Insured Name Merk Asset Number Vehicle Make Detail Chassis No Engine No Year Made STATUS
unit) No

1 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186699 W04DTRR76234 2019 RECEIVED
2 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 131 HD X Power PTO ? MJEC1JG43K5186698 W04DTRR76233 2019 RECEIVED
3 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 132 HD X Power PTO ? MJEC1JG43K5186693 W04DTRR76228 2019 RECEIVED
4 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186696 W04DTRR76231 2019 RECEIVED
5 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186689 W04DTRR76214 2019 RECEIVED
6 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186688 W04DTRR76213 2019 RECEIVED
7 PT. Agrajaya Baktitama 2/26/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186697 W04DTRR76232 2019 IN TRANSIT
8 PT. Agrajaya Baktitama 2/26/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186694 W04DTRR76229 2019 IN TRANSIT
9 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186691 W04DTRR76226 2019 RECEIVED
10 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186692 W04DTRR76227 2019 RECEIVED
11 PT. Agrajaya Baktitama 2/17/2020 HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186690 W04DTRR76225 2019 RECEIVED
12 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186680 W04DTRR76205 2019 IN TRANSIT
13 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186523 W04DTRR76108 2019 IN TRANSIT
14 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186633 W04DTRR76173 2019 IN TRANSIT
15 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186681 W04DTRR76206 2019 IN TRANSIT
16 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186675 W04DTRR76200 2019 IN TRANSIT
17 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186676 W04DTRR76201 2019 IN TRANSIT
18 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186677 W04DTRR76202 2019 IN TRANSIT
19 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186679 W04DTRR76204 2019 IN TRANSIT
20 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186682 W04DTRR76207 2019 IN TRANSIT
21 PT. Sumber Hasil Prima 24 FEB or 26 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186522 W04DTRR76107 2019 IN TRANSIT
22 PT. Sinar Sawit Andalan 26 FEB or 4 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186687 W04DTRR76212 2019 IN TRANSIT
23 PT. Sinar Sawit Andalan 26 FEB or 4 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186684 W04DTRR76209 2019 IN TRANSIT
24 PT. Sinar Sawit Andalan 26 FEB or 4 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186685 W04DTRR76210 2019 IN TRANSIT
25 PT. Sinar Sawit Andalan 26 FEB or 4 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186686 W04DTRR76211 2019 IN TRANSIT
26 PT. Sinar Sawit Andalan 26 FEB or 4 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5186683 W04DTRR76208 2019 IN TRANSIT
27 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187302 W04DTRR76707 2019 IN TRANSIT
28 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187298 W04DTRR76703 2019 IN TRANSIT
29 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187300 W04DTRR76705 2019 IN TRANSIT
30 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187256 W04DTRR76681 2019 IN TRANSIT
31 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187257 W04DTRR76682 2019 IN TRANSIT
32 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187296 W04DTRR76701 2019 IN TRANSIT
33 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187258 W04DTRR76683 2019 IN TRANSIT
34 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187259 W04DTRR76684 2019 IN TRANSIT
35 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187295 W04DTRR76700 2019 IN TRANSIT
36 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187297 W04DTRR76702 2019 IN TRANSIT
37 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187299 W04DTRR76704 2019 IN TRANSIT
38 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187301 W04DTRR76706 2019 IN TRANSIT
39 PT. Nabire Baru 13 MAR or 20 MAR HINO Tobe advise 130 HD X Power PTO ? MJEC1JG43K5187255 W04DTRR76680 2019 IN TRANSIT
COVERAGE
Non Truck PickUp/Truck
Comprehensive and/or Total Loss Only :
Strike, Riot, Civil Commotion, Terrorism & Sabotage :
Act of God :
Third Party / Passenger Legal Liability (Combined L :
Personal Accident for Driver and Passenger per vehi :
Medical Expenses per vehicle / cycle :

CATEGORY / SUM INSURED

Comprehensive Total Loss Only
Non Truck
IDR. 0 - IDR. 75,000,000.00 :
IDR. 75,000,001.00 - IDR. 150,000,000.00 :
IDR. 150,000,001.00 - IDR. 300,000,000.00 :
IDR. 300,000,001.00 - IDR. 500,000,000.00 :
IDR. 500,000,000.00 - IDR. 800,000,000.00 :
Above 800,000,000.00 :

Pick Up / Box / Truck

0 - IDR. 1,000,000,000.00 :

Motorcycle
0 - IDR. 100,000,000.00 :

DEDUCTIBLE
Non Truck PickUp/Truck
Material Damage : IDR 200,000 IDR 300,000
TPL/PLL, PA, MEDEX : NIL NIL
SRCCTS and AOG : IDR 500,000 IDR 500,000
 Motorcycle

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Motor Cycle
IDR 100,000
NIL
IDR 500,000
 Insured
No. Date of Birth Merk Asset Number
Vehicle Make Detail
Register No Chassis No Engine No
Name

31-May-10
Agro Wana
1 Lestari- CK MITSUBISHI STRADA L200
Mitsubishi 257274 KH9026FB
MMBJNK7406F039953
4D56CK – 6963
 Sum Insured
Year Made
FY

2007 ###