CT100 Insurance
4
Agent/Broker Details Dev.Of.Code Agent/Broker Address : : : T el /F ax /Email: NA0000009!" EC #EDA$ D%&ECT BA0000'()(*! $ &A+E,- NO.( ,-ANT-%NAA&& %,AA BA1A& BOA&2#-3DE& ABAD-3DE&A BADAND-& A 4&ADE,-*0 00'0 A55essories A55esss 6 MOTOR INSURANCE CERTIFICAT E CUM POLICY SCHEDULE MOTORISED-TWO WHEELERS LIABILITY ONLY POLICY - ZONE B Policy No : Cover Note No : Insured's Code : Insured' s Name : Address : Tel /Fax /Email : 431!"#31#"$1%#3&3 - 631440! "EN#AT $E%%& NAN$E%%& (/) $A* $E%%&+ , N) 1-11-10/A+ ).. .)&TEC,NIC C)EE+ NA$(#,E% $)A%+ %I(TT: *E%A#+ TEANANA - !0110 2CE: 3000044 3000044 / / 3000044 / NA P'() P olicy N o : Cover Note %t : Issue ) i5e C ode : Issue )i5e Name : Address : Tel /Fax /Email : 431!"#31#"$1#3&3 431! C *E%A# % N): 1--3!/3+ 1st F))$+ )#)N%A+ NEA$ )% ( (TAN%+ ,&%E$AA% $)A%+ *E%A# T)7N+ *E%A# %I(T - !0 110 *E%A# TEANANA !0110 084! - 1166 / / 9via9a;umar<orientalinsuran5e5oin .eriod o Insuran5e : Colle5tion No = %t : F$)* 00:00 )N 11/0/01! T) *I%NI,T )F 10/0/016 C(, 6>300044 - 10/0/01! ross .remium : eo?ra@i5al Area : !14 IN%IA (ervi5e Tax : 64 (tam@ %ut9 : Area Extensi on : ! Total : !>8 P*'+ic,l*' o. I/,'(0 (2 icl(: R(i+'*+io / M*' 5 Pl*c( E/i/( No6 5 C2*i No6 M*( - Mo0(l Y(*' O. M*/,.*c+,'( Ty7( O. Bo0y S(*+i/ C*7*ci+y 8i/cl,0i/ D'i)('9 C,ic C*7*ci+y A. 3 34 %*E1881! - ABAB *)T)$C&CE-CT 100 004 ()) 1 1 > (an?aredd9 %FE0013 ()) Li;i+*+io/ * +o ,(: T2( Policy co)(' ,( o/ly ,/0(' * 7(';i+ <i+2i/ +2( ;(*/i/ o. +2( Mo+o' (2icl( Ac+ 1!== o' ,c2 * c*''i*( .*lli/ ,/0(' S,- (c+io/ 3 o. S(c+io/ %% o. +2( Mo+o' (2icl( Ac+ 1!==6 1 se onl9 or so5ial+ domesti5 and @leas ure @ur@oses and or t e insure d's Dusi ness or @roession Te .oli59 does not 5over use or ire or reard+ tuition+ ra5in?+ @a5e ma;in?+ reliaDilit9 trial+ s@eed testin?+ 5arria?e o ?oodsoter tan sam@les or @ersonal lu??a?eG in 5onne5tion it an9 trade or Dusiness or use or an9 @ur@ose in 5onne5tion it *otor Trade D'i)(' : An9 @erson in5ludin? te insured+.rovided tat a @erson drivin? olds an ee5tive drivin? li5ense at te time o te a55ident and is not disHualiied rom oldin? or oDtainin? su5 a li5ense+.rovided also tat te @erson oldin? an ee5tive earner's li5ense ma9 also drive te vei5le and tat su5 a @erson satisies te reHuirements o $ule 3 o te Central *otor "ei5les $ ules+ 18 Li;i+ o. Li*ili+y: U/0(' S(c+io/ II-I8i9 i/ '(7(c+ o. */y o/( *cci0(/+: * 7(' Mo+o' (2icl( Ac+> 1!==6 U/0(' S(c+io/ II-I8ii9 i/ '(7(c+ o. */y o/( cl*i; o' ('i( o. cl*i; *'ii/ o,+ o. o/( ()(/+ i R6 100000 Co) (' ,/ 0(' S(c+ io/ III . o' R( i +(' (0 O</( ' C,; D' i)(' 8CSI9 : R6 I/,'(0? D(cl*'(0 *l,( 100000 Fo' + 2( (2ic l( Fo' + 2( Si0 ( C*' No/ El(c+'ic*l Acc(o'i( El(c+'ic*l Acc(--o'i(- *l,( o. LP@#CN@ To+*l *l,(
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Transcript of CT100 Insurance
8/16/2019 CT100 Insurance
http://slidepdf.com/reader/full/ct100-insurance 1/4
Agent/Broker DetailsDev.Of.Code Agent/BrokerAddress
:
:
:
Tel /Fax /Email:
NA0000009!" EC #EDA$ D%&ECTBA0000'()(*! $ &A+E,-NO.( ,-ANT-%NAA&&%,AA BA1A& BOA&2#-3DE&ABAD-3DE&ABADAND-&A 4&ADE,-*000'0
A55essories A55esss 6
MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE
MOTORISED-TWO WHEELERS LIABILITY ONLY POLICY - ZONE B
Policy No :
Cover Note No :
Insured's Code :
Insured's Name :
Address :
Tel /Fax /Email :
431!"#31#"$1%#3&3
-
631440!
"EN#AT $E%%& NAN$E%%&
(/) $A* $E%%&+
, N) 1-11-10/A+ ).. .)&TEC,NICC)EE+ NA$(#,E% $)A%+ %I(TT:*E%A#+TEANANA - !01102CE: 3000044
3000044 / / 3000044 / NA
P'() Policy No :
Cover Note %t :
Issue )i5e Code :
Issue )i5e Name :
Address :
Tel /Fax /Email :
431!"#31#"$1#3&3
431!
C *E%A#
% N): 1--3!/3+ 1st F))$+ )#)N%A+
NEA$ )% ( (TAN%+ ,&%E$AA%$)A%+*E%A# T)7N+ *E%A# %I(T - !0 110
*E%A# TEANANA !0110
084! - 1166 / /9via9a;umar<orientalinsuran5e5oin
.eriod o Insuran5e :
Colle5tion No = %t :
F$)* 00:00 )N 11/0/01! T) *I%NI,T )F 10/0/016
C(, 6>300044 - 10/0/01!
ross .remium :
eo?ra@i5al Area :
!14
IN%IA
(ervi5e Tax : 64 (tam@ %ut9 :
Area Extension :
! Total : !>8
P*'+ic,l*' o. I/,'(0 (2icl(:
R(i+'*+io/ M*'5 Pl*c( E/i/( No6 5
C2*i No6M*( - Mo0(l
Y(*' O.M*/,.*c+,'(
Ty7( O. Bo0y
S(*+i/ C*7*ci+y 8i/cl,0i/ D'i)('9
C,icC*7*ci+y
A. 3 34 %*E1881! - ABAB *)T)$C&CE-CT 100 004 ()) 1 1 >
(an?aredd9 %FE0013 ())
Li;i+*+io/ * +o ,(:
T2( Policy co)(' ,( o/ly ,/0(' * 7(';i+ <i+2i/ +2( ;(*/i/ o. +2( Mo+o' (2icl( Ac+ 1!== o' ,c2 * c*''i*( .*lli/ ,/0(' S,-(c+io/ 3 o. S(c+io/ %% o. +2( Mo+o' (2icl( Ac+ 1!==6
1 se onl9 or so5ial+ domesti5 and @leasure @ur@oses and or te insured's Dusiness or @roession Te .oli59 does not 5over use or ire or reard+ tuition+ ra5in?+ @a5e ma;in?+ reliaDilit9 trial+ s@eed testin?+ 5arria?e o ?oodsoter tan sam@les or @ersonal lu??a?eGin 5onne5tion it an9 trade or Dusiness or use or an9 @ur@ose in 5onne5tion it *otor Trade
D'i)(' : An9 @erson in5ludin? te insured+.rovided tat a @erson drivin? olds an ee5tive drivin? li5ense at te time o te a55ident and is notdisHualiied rom oldin? or oDtainin? su5 a li5ense+.rovided also tat te @erson oldin? an ee5tive earner's li5ense ma9 also drive tevei5le and tat su5 a @erson satisies te reHuirements o $ule 3 o te Central *otor "ei5les $ules+ 18
Li;i+ o. Li*ili+y:
U/0(' S(c+io/ II-I8i9 i/ '(7(c+ o. */y o/( *cci0(/+: * 7(' Mo+o' (2icl( Ac+> 1!==6
U/0(' S(c+io/ II-I8ii9 i/ '(7(c+ o. */y o/( cl*i; o' ('i( o. cl*i; *'ii/ o,+ o. o/( ()(/+ i R6 100000
Co)(' ,/0(' S(c+io/ III .o' R(i+('(0 O</(' C,; D'i)(' 8CSI9 :R6
I/,'(0? D(cl*'(0 *l,(
100000
Fo' +2( (2icl( Fo' +2( Si0( C*'
No/ El(c+'ic*lAcc(o'i(
El(c+'ic*lAcc(--o'i(-
*l,( o. LP@#CN@ To+*l *l,(
8/16/2019 CT100 Insurance
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.la5e - *E%A#
%ate 10/0/01!
8/16/2019 CT100 Insurance
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BA,%C T4 CO7E&BA,%C T4 TOTAADD :4A FO& O8NE& D&%7E&&!)A T4 TOTA TOTA 4&E#%2# ADD :,E&7%CE TA ,TA#4 D2T3 TOTA A#O2NT
).00).00*0.00*'.00*'.00).000.*0
*;".00
A55essories A55esss 6
Atta5ed to and ormin? @art o @oli59 numDer 431!"#31#"$1#3&3
SCHEDULE OF PREMIUM
A )7N %A*AE IAIIT&
D(0,c+il( ,/0(' S(c+io/-I :
%etails o I*T Endorsements and $ also availaDle on internet TAC eDsite ta5or?inG
,9@ote5ation A?reement it: -
,ire .ur5ase/essor A?reement it: -
In te event o a 5laim under te @oli59 ex5eedin? $s1la5 or a 5laim or reund o @remium ex5eedin? $s1la5+te insured ill 5om@l9 itte @rovisions o te A* @oli59 o te Com@an9Te A* @oli59 is availaDle in all our o@eratin? )i5es as ell as 5om@an9's eDsite
T2( i/,'*/c( ,/0(' +2i 7olicy i ,(c+ +o co/0i+io/> cl*,(> <*''*/+i(> (cl,io/> IMT */0 OIC (/0o'(;(/+ ;(/+io/(02('(i/ *o)( <2ic2 *'( *)*il*l( o/ Co;7*/y? <(i+(: <<<6o'i(/+*li/,'*/c(6o'6i/ o' o/ 0(;*/0 .'o; +2( 7olicy i,i/ o..ic(
7arranted tat in 5ase o disonour o @remium 5eHuesG te Com@an9 sall not De liaDle under te @oli59 and te @oli59 sall De voidaDinitio rom in5e@tionG
Claim is not admissiDle i %rivin? i5en5e is ound a;e or is not valid eter or not in te ;noled?e o te insuredI/7e ereD9 5erti9 tat te @oli59 to i5 te 5ertii5ate relates as ell as tis 5ertii5ate o insuran5e are issued in a55ordan5e it te@rovision o Ca@ter and Ca@ter I o *otor "ei5les A5t+ 188
In itness ereo te undersi?ned Dein? autorised D9 and on Deal o te 5om@an9 as/ave erein to set is/teir ands at *E%A# on10-(E.-14I*.)$TANT N)TICETe Insured is not Indemniied i te vei5le is used or driven oterise tan in a55ordan5e it tis (5edule An9 @a9ment made D9 te Com@an9 D9 reason o ider terms a@@earin? in te Certii5ate in order to 5om@l9 it te *"A5t+ 188 is re5overaDle rom te Insured (ee te Clause eaded JA")I%ANCE )F CE$TAIN TE$*( AN% $I,T( )F $EC)"E$&J
Entered 9 :
Examined 9 :
&"IBA&A #*A$
&"IBA&A #*A$
For and on Deal o
Te )riental Insuran5e Com@an9 imited
Autorised (i?nator9
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In 5ase o an9 Huer9 re?ardin? te .oli59 @lease 5all Toll Free No 1800 11 848! and 011 330848!
