Anita Devi Insurance

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BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED


(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of
India [IRDA] vide Reg No.113)
Regd. Office: GE Plaza, Airport Road, Yerwada,Pune-411006(India)
TWO WHEELER PACKAGE POLICY SCHEDULE
UIN:IRDAN113RP0008V01201819
Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons, etc:
BAJAJ ALLIANZ GENERAL INSURANCE CO LTD, 3RD FLOOR NARAIN BUILDING, SHAHNAZAF ROAD, HAZRATGANJ , LUC-
KNOW-226001 PH:0522-2200553/2200554
INSURED DETAILS POLICY DETAILS
Insured Name ANITA DEVI Policy Number OG-20-1301-1826-00002193
W/O RAMNIWAS VILL/POST IN- Policy Issued on 29-MAY-2019 18:04 PM
DALPUR, BANDA TTEHSIL POWAY-
Insured AN , BANDA SHAHJAHANPUR, For Own Damage Section
Address SHAHJAHANPUR, UTTAR PRADESH-
242042 From : 29-MAY-2019 18:04 (Hrs)
Geographical India To : 28-MAY-2020 Midnight
Area
Customer ID Policy Period For Third Party Liability Section
149067403
From : 29-MAY-2019 18:04 (Hrs)
Bank Reference To : 28-MAY-2024 Midnight
No 1
Cover Note
/
GSTIN / UIN NA Details
STATE CODE / 09 - Uttar Pradesh
NAME Previous Policy No 0

Invoice No

Make & Mod-


Registration Number Place of Registration Engine Number Chassis Number SubType
el
ES ALLOY
MD625GF16J1E21
NEW SHAHJAHANPUR LF1EJ1812869 TVS - VICTOR DISC (110
487
CC)
Year Of Manufactur-
NCB % CC Seating Capacity Hypothecation Details
ing
0 110 2 2019 INDUSIND BANK LTD
Non electrical Electrical/Elec- Value of CNG/
Vehicle IDV Value For Side Car Total Value
accessories tronic accessories LPG kit
55925 0 0 0 0 55925
Own Damage Premium(Rs.) Liability Premium(Rs.)
Own Damage Premium 315 Basic Third Party Liability 3035
Special Discount Total Act Premium - B 3035
Total OD Premium - A 315
Total Premium (Net Premium) (A+B) 3350
State GST (9%) 302
Central GST (9%) 302
Final Premium ( Rupees Three Thousand Nine Hun- 3954
dred Fifty Four Only )
**Note: The above Total OD Premium is inclusive of all applicable Loading /Discounts viz (Automobile association membership, Voluntary Excess,
Anti Theft, Handicap Person, Driver Tuition, Fiber Glass, CNG/LPG Unit, Geographical Extension, Imported Vehicle Etc. wherever Applicable)

Broker Code 56179296 Contact No. 9670366667/00000000000


For help and more information:
Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, 1800-22-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call) Email us at Ba-
[email protected] or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 29-May-2019 18:17:16 PM- Silent_Printing (Web) (18522020)

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