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Bajaj Allianz General Insurance Company LTD
Bajaj Allianz General Insurance Company LTD
Bajaj Allianz General Insurance Company LTD
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
DL3SCE787 NOV-2013 BAJAJ AVENGER STD PETROL 220 2013 2
6 220
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.)
PDZCDF49978 MD2A22EZX 0 0 0 0 0
DCF51491
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-20-9906-1806-00017387 Product Two Wheeler -Liability Only Policy
Period Of Insurance From: 07-May-2019 Policy issued on 06-May-2019 -
To: 06-May-2020 Midnight Cover Note No /
Application No Scrutiny No 115569771
Insured Name SUMIT KUMAR DHINGRA Zone B
Insured Address FLAT NO 400, SUNSHINE APARTMEN, T
125-A NEB SARAI, SAKET, ,, DELHI - 110068
Customer ID 146832706 Premium Payer ID 146832706
Transaction Id
Policy Status ISSUED
GSTIN / UIN NA STATE CODE / NAME 07 - Delhi
Invoice No. 119011164/1
Registration Make SubType Model CC Mfg year Seat Cap Vehicle/Trailer Engine Number
No. Chassis No
DL3SCE7876 BAJAJ STD AVENGER 220 220 2013 2 MD2A22EZXDCF5 PDZCDF49978
1491
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 985
Total Liability Premium: 985
Additional loading @ 0% 0
Contact No : 8448286002/1800-103-3999
Email - insurerdata@policybazaar.com
Damage Details as per Annexure I
Premium Collection Details :- [Receipt No/Collection No/Amount] 9906-02560190 / 115569771 / Rs. 1162 ,
*** 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'.
115569771/-/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
Printed , Signed and Executed at Pune
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No.
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.BAGIC GST No : 27AABCB5730G1ZX | Princip-
al Location : GE Plaza, 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 - 06-May-2019 13:16:34 PM (Web)
MH012871737201819M Defaced No. 0007392478201819 Order No.CSD/386/2019/1303/19 Order
Dated 20.03.2019Defaced date dated 18-MAR-19 timing 17:07:14 of General Stamp Of-
fice,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.BAGIC GST No : 27AABCB5730G1ZX | Princip-
al Location : GE Plaza, 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 - 06-May-2019 13:16:34 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