3/6/23, 12:21 PM Quotation

Quotation Date : 06 March 2023

Quotation Valid Until : 05 April 2023

AXA AFFIN GENERAL INSURANCE

BERHAD

Service Tax Reg No: W10-1808-31015017

Agency Name: CHAN SHUET YIN Agency Tel No:     Fax No:
NO 43, JALAN 5/149K ZONE N BANDAR
Account Code: 39128 Address:
BARU SERI PETALING 57000
Serv.T Reg. No. :    

MOTOR QUOTATION SLIP FOR NEW BUSINESS

Name  MS CHUA PEI KIAN
Address  NO 21 JALAN 37 
TAMAN DESA JAYA KEPONG 

52100 KUALA LUMPUR WILAYAH PERSEKUTUAN

IC / Business Registration No 861109-56-5916 (new)
Passport No
Telephone Number  60122778815 (Mobile)

SCHEDULE
Make & Model of Cubic Capacity H.P. of
PERODUA AXIA 1000 SE (CVT) 998.0CC
Vehicle Tonnage
Vehicle Body HATCHBACK Agreed Value 37,000.00 
Registration No VHD9301 Compulsory Excess / Excess
RM 400.00 / RM 0.00
Vehicle Registration Damage Claim
NA
Card No PRIVATE USE (AXA
Use of Vehicle
Year of Manufacture 2021 SMARTDRIVE SHARING)
Engine No H29D25C Smartdrive Private Car -
Cover Type Private Use (axa Smartdrive
Chassis No PM2B200S003527182
Sharing)[comprehensive]
Seat Capacity 5 Vehicle Type SMART DRIVE PRIVATE CAR
Effective Date 06/03/2023 to 05/03/2024
Premium(RM) 1,602.99
Extra Benefit ALL DRIVERS
Service Tax (6.00 %) 96.18
specified DPP - PLAN A (WITH UNLIMITED
TOWING)
Stamp Duty 20.00
AXA SMARTDRIVE SHARING
Total Due 1,719.17
Additional Named Total Due- Amount Payable
NA 1,719.15
Driver (Rounded)

For more information on terms and conditions of our insurance coverage, you may refer to our Product Disclosure Sheet (PDS)
at https://www.axa.com.my/motor-and-home

Compulsory Excess

In addition to the Excess shown in the Schedule, We have the right to deduct another RM400 as Compulsory Excess if at the
time of the Incident, You or the person driving Your Car with Your consent:

Is under 21 years old; or

Holds a Provisional (P) or Learner (L) driver‚s license; or
Is not named in the Schedule as Named Driver

We will not deduct this additional RM400 Excess if the loss or damage is caused by fire, explosion, lightning, burglary,
housebreaking, theft, third party property damage or bodily injury claims.

Excess Damage Claim - Refers to the excess amount you have agreed to pay on the own damage claim as specified in your
Policy during the Period of cover.

Premium Pricing RM
Basic Premium 1,330.78
All Rider Premium 0.00
-NCD(25.00%) 332.70
+Additional Coverage  
ALL DRIVERS 20.00
DPP - PLAN A (WITH UNLIMITED TOWING) 84.91
https://w6.financial-link.com.my/Agency/showquo.jsp?qno=16782518202211291124mh391&stat=O&finalquo=Y 1/2
3/6/23, 12:21 PM Quotation
AXA SMARTDRIVE SHARING 500.00
Gross Premium  1,602.99
+Stamp Duty 20.00
+Service Tax (6.00 %) 96.18
Gross Due  1,719.15

https://w6.financial-link.com.my/Agency/showquo.jsp?qno=16782518202211291124mh391&stat=O&finalquo=Y 2/2