Escolar Documentos
Profissional Documentos
Cultura Documentos
Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune
A. Proposer details
B.Vehicle Details
Registration
Month / Vehicle Vehicle Vehicle Fuel Type Cubic Ca- Year of Man- Seating Capa-
Number Year of Make Model Sub Type pacity/ ufacture city
Regn Kilowatt
BR01BB715 APR-2011 HERO MO- PASSION CAST PETROL 100 2011 2
0 TOCORP PRO SELF
DRUM
Engine Num- Chassis Num- Vehicle IDV Electrical Non-Electrical Ac- CNG/LPG Unit Total IDV (in Rs.)
ber ber (in Rs.) IDV (in Rs.) cessories IDV (in (Extra fitted)
Rs.) IDV (in Rs.)
HA10EDBGD1 MBLHA10EW 0 0 0 0 0
1401 BGD31485
C. Coverage opted
Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons,
etc; Bajaj Finserv Building, 1st Floor, Behind Weikfield IT-Park, Viman Nagar, Pune-411014 Phone No :1800-209-0144
Policy Number OG-20-9906-1806-00096147 Product Two Wheeler -Liability Only Policy
Period Of Insurance From: 12-Sep-2019 Policy issued on 11-Sep-2019 -
To: 11-Sep-2020 Midnight Cover Note No /
Application No Scrutiny No 128546029
Insured Name SIMA KUMARI Zone B
Insured Address SULTANPUR MATH, TRIMURTI NAGAR, ,
DANAPUR CANTT, PATNA, ,, PATNA -
801503
Customer ID 160678245 Premium Payer ID 160678245
Transaction Id
Policy Status ISSUED
GSTIN / UIN NA STATE CODE / NAME 10 - Bihar
Invoice No. 128765926/1
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
BR01BB7150 HERO MOTO- CAST SELF PASSION PRO 100 2011 2 MBLHA10EWBGD HA10EDBGD1140
CORP DRUM 31485 1
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 752
Total Liability Premium: 752
Additional loading @ 0% 0
Contact No : 0/1800-103-3999
Email -
Damage Details as per Annexure I
Premium Collection Details :- [Receipt No/Collection No/Amount] 9906-02987987 / 128546029 / Rs. 887 ,
*** 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 PDA MODULE
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 'Bagichelp@bajajallianz.co.in'.
128546029/-/10043080/99060001/-
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.
Authorized Signatory This document is digitally signed, hence counter signature / stamp is not required
Printed , Signed and Executed at Pune
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.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 - 11-Sep-2019 12:09:53 PM (Web)
Regd Office : Bajaj Allianz House,Airport Road, Yerwada Pune-411006 (India), A Company incorporated under Indian Companies Act, 1956 and licensed by In-
surance Regulatory and Development Authority of India [IRDA] vide Reg No.113, Corporate Identification Number U66010PN2000PLC015329.
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No. MH003753522201920M Defaced No. 0002277216201920 ORDER
NO.CSD/93/2019/3587/19 ORDER DATED 24.07.2019DEFACED DATE dated 23-JUL-19 timing 15:54:05 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.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 - 11-Sep-2019 12:09:53 PM (Web)
Bajaj Allianz General Insurance Company Ltd.
Bajaj Finserv Building, 1st Floor, Behind Weikfield IT-Park, Viman Nagar, Pune - 411014
Contact No:Contact No: 1800-209-0144
RECEIPT
Authorised Signatory