PREMIUM COMPUTATION SHEET

Department : MOTOR Insured's Name : Mr MAHENDRAKUMAR CHIMANLAL

LIMBACHIA
Document No : R/141400/31/2022/67
Document Date : 02/12/2021

Policy Start Date : 28/12/2021 Policy End Date : 27/12/2022

Product Description : MOTORISED-TWO WHEELERS Document Type : Proposal

Policy Type : PACKAGE POLICY

SCHEDULE OF PREMIUM
Cover Description Sum Insured Premium

BASIC OD COVER 13,500.00 247.86

MOTOR OD BASIC - NEW 13,500.00 173.86
LESS :UNDERWRITER DISCOUNT 0.00 74.00
BASIC OD TOTAL 13,500.00 173.86
OD TOTAL 13,500.00 174.00
LESS :NO CLAIM BONUS-GR27 0.00 86.93
ADD :OD Round off Loading 0.00 13.07
MOTOR TOTAL OD 13,500.00 100.00
BASIC TP COVER 0.00 752.00
BASIC TP TOTAL 1,00,000.00 752.00
TP TOTAL 1,00,000.00 752.00
TOTAL PREMIUM 852.00
ADD :SGST 77.00
ADD :CGST 77.00
STAMP DUTY 0.50
TOTAL AMOUNT 1,006.00

RISK DETAILS

Section : PACKAGE POLICY

Vehicle Details : HA10EC9GLO7500 / MBLHA10EN9GL12773 / GJ 01 LM 1940

Cover Name Sum Insured Rate Premium

BASIC OD COVER 13,500.00 1.836/100 247.86

UNDERWRITER DISCOUNT 0.00 30/100 74.00
NO CLAIM BONUS-GR27 0.00 50/100 86.93
OD Round off Loading 0.00 13.07
BASIC TP COVER 0.00 752/1 752.00

Total 852.00