Professional Documents
Culture Documents
Bajaj Allianz General Insurance Company LTD
Bajaj Allianz General Insurance Company LTD
Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune
A. Proposer details
1. Proposer Name : RANJEET KUMAR SAH
2. Proposer Address : MAHAVIR BHAWAN, DINA SAH LANE,, BEHIND AJANTA CINEMA,
MUNDICHAK
, , BHAGALPUR, BIHAR-812001
3. Proposer Mobile Number : 6207994018
4. Proposer Residential Number : NA
5. Proposer e-mail id : rksatbgp@gmail.com
6. Proposer Profession : NA
B.Vehicle Details
Registration Month / Year Vehicle Vehicle Vehicle Sub Cubic Capa- Fuel Type Year of Man- Seating Ca-
Number of Regn Make Model Type city/Kilowatt ufacture pacity
BR10V0904 APR/2016 HERO MO- SPLENDOR CAST 97 Petrol 2016 2
TOCORP PRO WHEEL
SELF
START
DRUM
Engine Number Chassis Number Vehicle IDV (in Electrical Non-Electrical CNG/LPG Unit Total IDV (in
Rs.) Accessories Accessories (Extra fitted) Rs.)
IDV (in Rs.) IDV (in Rs.) IDV (in Rs.)
HA10EYGHA23 MBLHA10CAG 26071 0 0 0 26071
225 HA17871
C. Coverage opted
Limitation as to Use The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of
goods( other than samples or personal luggage),Organised racing,Pace making, Speed testing,
Stamp
Duty Rs.
0.5
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No. MH011254450201920M Defaced No. 0006230296201920 ORDER NO.CSD/322/2020/740/2020
ORDER DATED 15.02.2020DEFACED DATE dated 15-FEB-20 timing 12:17:16 of General Stamp Office,Mumbai,India.
Principal Location : Bajaj Allianz House, Airport Road, Yerwada, Pune - 411006 PH:66026666 | Services Accounting Code : 997134 -
Motor vehicle insurance services. No reverse charge is payable on these services.
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