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Bajaj Allianz General Insurance Company LTD
Bajaj Allianz General Insurance Company LTD
Bajaj Allianz General Insurance Company Ltd.
GE Plaza, Airport Road, Yerwada, Pune - 411006(India)
CERTIFICATE CUM POLICY SCHEDULE
Policy Servicing Off: Bajaj Allianz General Insurance Co Ltd., Golden Heights,, 4th Floor, No.1/2, 59th "C" Cross, 4th "M" Block,, Bangalore-
560010 Phone No :080-67195000
Policy Number OG-18-1731-1831-00000261 Product Commercial Vehicle - Liability Only
Vehicle Type Passenger Carrying - 3 Wheel & Carrying Capacity <= 6
Period Of Insurance From: 12-Mar-2018 23:45 Policy issued on 12-Mar-2018 -
To: 11-Mar-2019 Midnight Cover Note No 0/
Application No 83452546 Scrutiny No
Insured Name MRS SHOBHA C Zone
Insured Address W/O B M MANJUNATHA, PATALAMMA LAY-
OUT, MALUR, KOLAR, MALUR, ,, KOLAR -
563130
Customer ID 114614970 Premium Payer ID 114614970
Transaction Id
Policy Status ISSUED
GSTIN / UIN NA STATE CODE / NAME 29 - Karnataka
Registration Make SubType Model CC Mfg year Seat Cap Vehicle/Trailer Engine Number
No. Chassis No
KA02C7907 BAJAJ 4 STROKE REAR ENGINE 145 2005 3 BMC14882 BMC15689
CNG - 145 CNG
AUTORICK-
SHAW
Vehicle IDV Elec Acc Non Elec Acc Trailer 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 5401
CNG / LPG Unit (IMT.25) 60
PA Cover For Owner-Driver Of Rs. 200000 100
LL For Operation/Maintenance For 1 Person 50
Total Liability Premium: 5611
Additional loading @ 0% 0
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]'.
83452546/-/10041892/-/0
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.
Regd. Office : GE Plaza, 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.BAGIC GST No : 29AABCB5730G1ZT | Princip-
al Location : Golden Heights, 4th Floor, No.1 / 2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010 PH:080-67195000 | Services Accounting Code : 997134 -
Motor vehicle insurance services. No reverse charge is payable on these services. | Invoice No. : 94615471/1 - Latest Schedule - 12-Mar-2018 13:08:36 PM (Web)
Authorized Signatory
Printed , Signed and Executed at Pune
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No.
MH010176711201718M Defaced No. 0005747963201718 dated 09-FEB-18 timing 13:12:55 of General
Stamp Office,Mumbai,India.
Generated by Silent_Printing
Regd. Office : GE Plaza, 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.BAGIC GST No : 29AABCB5730G1ZT | Princip-
al Location : Golden Heights, 4th Floor, No.1 / 2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010 PH:080-67195000 | Services Accounting Code : 997134 -
Motor vehicle insurance services. No reverse charge is payable on these services. | Invoice No. : 94615471/1 - Latest Schedule - 12-Mar-2018 13:08:36 PM (Web)