Vaade d i Ilisuntnce

.0 Regn. No. :
115 ICICI Lombard General

CERTIFICATECUM POLICY SCHEDULE

ORIGINAL
'OR von SUPPLIER.
TAX INVOICE.'CERTIFICATE POI.10'
POIicy (VORM or CENTRALMOTOR RULES.
Dund/edMotorrobcy• YrTP / 00 VducJe) 161010/01-Jw2020
NO,
Ofln•urutce Di-Jan-2020 (0
Policy On (00 00)
Samrm•oa •nom
.ph.c.' Area INDIA
AccounnnCock

State (Ode adesh- ace S"

SICAREGISTVRED
INSUREDMOTORVEI'ICLE DETAILS
INSUREDDECIARED VALUE (in Rs)
Make uzu\i Veh•cjc
Van"" CCESSDISCCBS/ACCESS
EJecuicaJ
Re sltanonNo
El«tnc•l Acce»orves
Vealoj 2019 CNG'LPGK"
AF212221J04 •
•ob.c(
Seating
solo

ScheduleOf Premium(.gmountin
Part A Year) & Part B (SYenr•sj
ehjcle SECTION
nurd Party
ec Accessones forO. Kit
on• Accessono PACove/ I Year)
A Coverfog2 of Rs (7tnÄ)) exh 16 490
UMT.2S)
'ow•ardsInbu•nCNGfLPG AreaEsm (IMT•I) 1
to (JMT•29»

amp, Ives eic. (IMT 23)

O Liability rreøuuro Uj
TuitionLoadingOnOD Premium(60%)
4898
'bet GlassTank GST
82
Gsr am'. 440 82
b-TotaIAdditions rag Premium
O raid
uctibles
M • ComaÜo•i
('MT 22A)
Dcvce(IMT.

'0 the or cheqoc

iot designedfoi 2 •tams paid
The ('SIT
dd • On Coverages
o UIN IKOANllSRP0007V0120it19
ero Depreciation
242

e'un•

Damage Premium (A)

t)etails • Nominee Name
elation Fatho
Slethod 'hcque ransaction Bank Name
Cheque Amount
DANK OF UAROOA
Financier Type NotEmanced FinancierName NA Financier Branch
IONS AS TO USE : The Policycoversuse of the vehicle any purposeotherthx, orReward(2) oieoods
0) Orgauzed
DRIVER : Any including.nswed Provi'kdthata persondnv.ngholds the Md•Snot
idea 'he (rom
hold,ngan effectiveI-earner'sLicensemay dove'he andthat a 'h: requ•remmts
or Rule of 'he Central •
Limitsof toability:UnderSect.o„ 0) of ihe • bodily • sushamountas necesorytomee'die orthe VehiclesRula. 1980
Act. Undet • or 'be
Deduct.blewuieJ •l RS100(CompulsoryDeductibleRs 100 Deductible VoluntaryDeductible

http://l O.52.4.5/Maruti
01-Jan-20

This Policy is sourced through Maruti Insurance Broking Private Limited, Direct Broker
(General) IRDA' License NO. : 428 (Valid Till : 01-02-2018)

For Policy Terms and Conditions Log on to : www.marutiinsurance•com'

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