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Invoice

04/03/2022 15:04:36
Mr. T S Weerathunga,
287/7C
Panadura.

Invoice No : V2206302578120 Our VAT No : 134051795-7000


Date of Issued : 2022-03-04 Our SVAT No : SVAT007219
Your VAT No :
Your SVAT No :
Type of product : Comprehensive (SL)
Policy No : LP8013937177
Endorsement From :
Vehicle No : WP KO-9343
Period of Cover : From 2022-03-04 To 2023-03-04 00:00 Hrs
Sum Insured : LKR 4,665,000.00

Insured person : Mr. T S Weerathunga,


,
287/7C ,
Panadura.

Customer ID : 100212777
Agent Code & Name : 0012335 InsureMe Insurance Brokers (Pvt) Ltd (NDB Banka as
Introducer Code & Name : 0002933 Basura Chathumal Ekanayaka Kalupahana

Premium Computation

LKR
Basic : 43,735.66
Strike & Riot : 9,330.00
Terrorism Cover : 2,332.50
Premium before taxes : 55,398.16

Cess : 166.19
Policy Fees : 500.00
Road Safety Tax : 10.00
Stamp Duty Tax : 56.00
NBT : 0.00
VAT : 4,485.95
Total Amount Due : 60,616.30
Amount in words : Sixty Thousand Six Hundred Sixteen Rupees And Thirty Cents

Cheques should be drawn in favour of Allianz Insurance Lanka Limited and crossed A/C payee only.

For the Premium Payment Warranty Clause & online payments Please visit our web page www.allianz.lk

This is a computer generated document hence no signature is required.

Allianz Insurance Lanka Limited, No: 675 Dr Danister De Silva Mawatha, Colombo - 09, Sri Lanka.
Tel: 0112303300 Email: info@allianz.lk

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