Great Eastern General Insurance (Malaysia) Berhad (102249-P)

(Formerly known as Overseas Assurance Corporation (Malaysia) Berhad)

Level 18, Menara Great Eastern, 303, Jalan Ampang, 50450 Kuala Lumpur
General Line: +603 4259 8888 Fax: +603 4813 0055
Customer Service Careline: 1300-1300 88 Website : www.greateasterngeneral.com

Motor Insurance Cover Note

JPJ Code / Kod JPJ: 86
Road Transport Act 1987 (Malaysia)
Motor Vehicles (Third Party Risks) Rules 1959 (Malaysia)
Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore
Motor Vehicles (Third Party Risks Compensation) Rules 1960 (Republic of Singapore)
Motor Vehicles (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam
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Whereas the Proposer named in the Schedule below having proposed for insurance and paid the Sum as stated below in respect of the Motor Vehicle described in the Schedule below the risk is hereby HELD COVERED in the
terms of the Company's usual form of policy applicable there to for the period as stated below unless the cover be terminated by the Company by notice in writing in which case the insurance will there upon cease and the Company
will return a proportionate part of the premium already collected for such insurance after due allowance for the period the Company has been on risk.
____________________________________________________________________________________

SCHEDULE
Insured Name : GOLDEN BORNEO PALM SDN BHD
Postal Address : TB 8283 LOT 20C, Cover Note No. : JX261316
PERDANA SQUARE COMMERCIAL Date Issued : 05/06/2020
CENTRE, MILE 3.5, ROAD Policy No. : VX186586
TAWAU

Occupation
Identity Card No. : (New) (Old) : -
Business Reg No. : 1133717-V Passport No. : -
Period of Insurance : From 05/06/2020 till midnight : 04/06/2021
Registration No. : SD9505A Engine No. : 3L-4091930
Make/Model : TOYOTA/TOYOTA LH80 PICK-UP Chassis No. : LN106-0133497
Type of body : PICK UP Year of Manufacture : 1996
Hire Purchase Owner :
Type of Cover : THIRD PARTY, FIRE & THEFT (NON TARIFF)
Seating Capacity : 2
C.C/Tonnage : 2779 CC Premium(RM) : 546.65
Sum Insured(RM) : 20000.00 Excess(RM) : 0.00
Log Book No. : NCD Entitlement(%) : 0.00 (0.00%)

Named Driver(s) :

Extension of Cover(if any) :

JPJ eInsurance Status : ACCEPTED BY JPJ

I/We hereby certify that this covering note is issued in accordance with the provisions of Section IV of the Road Transport Act 1987 (Malaysia) Motor Vehicles (Third Party
Risks)Rules 1959 (Malaysia) Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore Motor Vehicles (Third Party Risks
Compensation) Rules 1960 (Republic of Singapore) Motor Vehicles (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam
Great Eastern General Insurance (Malaysia) Berhad
(Approved Insurers)

VHKK0258 ______________________________________________
Agent Code :
Authorised Signature
Dear Policy owners, kindly contact our nearest GEGM branch or your servicing agent if you have not received your motor policy within one month after receiving this
motor e-cover note confirmation slip from your agent.
Please be advised that the premiums on this policy may be subject to Service tax. In the event that Service tax does apply to your policy, a revised debit note/invoice will be
issued to you. Thank you.