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Gross

SL No. Type /ofVehicle


Equipment Model & year Description of the invoice value per unit(without
Make No. of vehicles Weight/Veh CC
vehicle P&F,Frieght,Insurance,Tax) icle

Ready Built
1 Dust Tanker

Note: Please fill the Relevant coloumns


Pertaining to you.

Please submit the invoice value per


vehicle excluding P&F, freight,Insurance
,Tax etc
Coverage for Any other
engine no. chassis no. Registration No. No. of persons Claim status additions
inclding driver Information
nvoice value of vehicle excluding P&F ,Freight,Insurance Etc.

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