Putrajaya118 JSP

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THE PACIFIC INSURANCE BERHAD (Company. No.

91603-K)
40-01, Q-Sentral, 2A Jalan Stesen Sentral 2,
Kuala Lumpur Sentral, 50470 Kuala Lumpur.
P.O. Box 12490, 50780 Kuala Lumpur
Tel : 03 - 2633 8999 Fax : 03 - 2633 8998
Website: www.pacificinsurance.com.my
Toll-free: 1-800-88-1629

MOTOR QUOTATION SLIP FOR NEW BUSINESS


Name JUTA ASIA PROPERTIES SDN BHD
Address 60 JALAN KERUING TAMAN BUKIT BANDARAYA BANGSAR
IC/Business Registration 682695-D
Passport No
Telephone Number
Agent Code V0009839
SCHEDULE
Make & Model of PORSCHE MACAN Cubic Capacity H.P. of 2997.0CC
Vehicle Tonnage
Vehicle Body SEDAN Sum Insured 289,000.00
Registration No PUTRAJAYA118 Excess 0.00
Vehicle Registration 10308564 Use of Vehicle PRIVATE CAR
Card No
Year of Manufacture 2015 Cover Type Private Car -
Comprehensive
Engine No CTM023496 Vehicle Type Private Car
Chassis No WP1ZZZ95ZFLB72262 Premium(RM) 3,983.54
Seat Capacity 5 Stamp Duty 10.00
Effective Date 14/07/2020 to 13/07/2021 Service Tax 215.11
Extra Benefit specified 1)ALL DRIVERS Total Due 3,810.30
2)WINDSCREEN GLASS(RM5,000.00)
Additional Named NA Vehicle Color
Driver

QUOTATION
Premium Pricing RM
Basic Premium 7,074.54
All Rider Premium 0.00
-NCD (55.00%) 3,891.00

+Additional Coverage
ALL DRIVERS 50.00
WINDSCREEN GLASS(RM5,000.00) 750.00
Gross Premium 3,983.54
-Discount(10.00%) 398.35
Premium After Discount 3,585.19
+Service Tax (6.00 %) 215.11
+Stamp Duty 10.00
Gross Due 3,810.30

Excess : Compulsory RM 400.00


: Voluntary RM 0.00

ENDORSEMENTS AND CLAUSES:-


B02F ENDORSEMENT 2(F) - COMPULSORY EXCESS
B030 ENDORSEMENT 30 - REPLACEMENT PARTS
W002 ENDORSEMENT 106 - INSURER'S AUTHORISED WORKSHOP
B089 ENDORSEMENT 89 - BREAKAGE OF GLASS IN WINDSCREEN, WINDOW OR SUNROOF
B203 ALL DRIVERS (FOR COMPANY CAR)

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