Scribd
Upload
263 views1 page

Mh03ae9220 Nadeem Office PDF

This document is a liability only policy certificate for a two-wheeler issued by Bajaj Allianz General Insurance Company Ltd. It provides insurance coverage from March 10, 2020 to March 9, 2021 for a Bajaj Pulsar 150 electric motorcycle owned by Badre Alam Shamuddin Ansari. The key details include a premium of Rs. 828, coverage for third party liability up to the requirements of the Motor Vehicles Act, and coverage for third party property damage up to Rs. 6,000. The policy covers any licensed driver but not commercial uses like ride-sharing.

Uploaded by

Nehal Ansari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
263 views1 page

Mh03ae9220 Nadeem Office PDF

This document is a liability only policy certificate for a two-wheeler issued by Bajaj Allianz General Insurance Company Ltd. It provides insurance coverage from March 10, 2020 to March 9, 2021 for a Bajaj Pulsar 150 electric motorcycle owned by Badre Alam Shamuddin Ansari. The key details include a premium of Rs. 828, coverage for third party liability up to the requirements of the Motor Vehicles Act, and coverage for third party property damage up to Rs. 6,000. The policy covers any licensed driver but not commercial uses like ride-sharing.

Uploaded by

Nehal Ansari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1





Bajaj Allianz General Insurance Company Ltd.
Bajaj Allianz House, Airport Road, Yerwada, Pune - 411006(India)
LIABILITY ONLY POLICY FOR TWO WHEELER CERTIFICATE CUM POLICY SCHEDULE

Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons,
etc; Bajaj Allianz General Insurance Co Ltd, 952/954 Appa Sahab Marathe Marg,Prabhadevi, Nr Chetanya Twr, Next to Saraswat
Bhawan,Dadar (W), MUMBAI-400025 Phone No :022-66628666
Policy Number OG-20-1901-1806-00140605 Product Liability Only Policy For Two Wheeler
Period Of Insurance From: 10-Mar-2020 00:01 Policy issued on 09-Mar-2020 -
To: 09-Mar-2021 Midnight Cover Note No /
Application No 163028381 Scrutiny No
Insured Name BADRE ALAM SHAMUDDIN ANSARI A Zone
Insured Address ASHRAF COLONY A WING 4TH FLR , RM NO
402 NR AMMAR TWR KAUSA MUMBRA
THANE, ,KAUSA, THANE - 400612
Customer ID 179619925 Premium Payer ID 121887279
Transaction Id
Policy Status ISSUED
GSTIN / UIN NA Place of Supply/State 27 - Maharashtra
Code/Name
Invoice No. 152443996/1
Company GST No 27AABCB5730G1ZX
Company PAN No AABCB5730G
Registration Make SubType Model CC/KW Mfg year Seat Cap Vehicle/Trailer Engine Number
No. Chassis No
MH03AE9220 BAJAJ ELECTRIC PULSAR 150 150 2006 2 CC8723 C19117
START

Vehicle IDV Elec Acc Non Elec Acc Side Car Trailer Reg No CNG/LPG Unit Total Sum Insured
0 0 0 0 0
SCHEDULE OF PREMIUM
OWN DAMAGE LIABILITY
Total Own Damage Premium: Basic Third Party Liability 702
Total Liability Premium: 702
Additional loading @ % 0

Total premium 702


Special Discount
Net Premium 702
State GST (9%) 63
Central GST (9%) 63
Final Premium Rs. 828 ***All premium Figures are in Rupees
Geographical Area : No Claim Bonus : 0%
Nominee Details Name : NA Relationship : NA

Nominee Details Name : Relationship :


LIMITS OF LIABILITY: Under Section II-1(i) of the policy -> Death of or bodily injury : Such amount as is necessary to meet there requirements of the Motor
Vehicles Act,1988. Under Section II-1(ii) of the policy -> Damage to Third Party Property : Rs.6000/-
LIMITATION AS TO USE: The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal
luggage), Organised racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.
DRIVER : : Any person including the insured :Provided that a person driving holds an effective driving licence at the time of the accident and is not disquali-
fied from holding or obtaining such a licence. Provided also that the person holding an effective Learner's licence may also drive the vehicle and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
IMPORTANT NOTICE: The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by
the Company by reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See
the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY".
Subject To IMT Endorsement Nos : 20, & Policy wordings attached herewith
Warranted that insured named herein or owner of the vehicle insured holds a valid Pollution Under Control (PUC) and
/ or Fitness Certificate on the date of commencement of the Policy. If the PUC and/or Fitness Certificate is not found to
be valid on the date of commencement of the Policy, the Company reserves its right to consider the policy void ab ini-
tio.
Agency Code BAG100016904 Channel Name : ML
Agency Name : SAMEER AHMED
Contact No : 8655020146/9768010146
Email - [email protected]
Damage Details as per Annexure I
Premium Collection Details :- [Receipt No/Collection No/Amount] / Rs. 828 By Float No : NF
*** If premium paid through cheque, the policy is void ab-initio in case of dishonour of cheque.
This certificate of insurance is issued in accordance with the provision of Chapter X and Chapter XI of M.V. Act, 1988.
Damage Details Annexure : - NA
Remarks -

In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858 (Toll Free) / 91-020-30305858
(chargeable, add area code before this number in case of mobile call) or email us at '[email protected]'.
163028381/-/10059289/NA/-
This is a one page Policy Document [without enclosing the Terms and Conditions (T&C) of the Policy] issued by the Company, pursuant to the authorization of Insured to display the T&C of the Policy on its website (www.bajajallianz.com) that enables access by the In-
sured. The T&C of the Policy are available on the Company's website and can be accessed by the Insured.
Kindly contact our nearest / local office(s) for No Claim Bonus Confirmations.

This is the 'Digital Print' and original Policy would follow and the Original policy, duly countersigned, to be relied on for all legal purposes.

For & On Behalf of Bajaj Allianz General Insurance Company Ltd.

Regd. Office : Bajaj Allianz House, Airport Road, Yerawada,Pune - 411006 (India),A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance
Regulatory and Development Authority of India [IRDA] vide Reg No.113, Corporate Identification Number U66010PN2000PLC015329.Principal Location : Bajaj Allianz
House, Airport Road, Yerwada, Pune - 411006 PH:66026666 | Services Accounting Code : 997134 - Motor vehicle insurance services. No reverse charge is payable on
these services. - Latest Schedule - 09-Mar-2020 19:23:54 PM (Web)

You might also like