RENEWAL SCHEDULE - MOTOR PERFECT (COMPREHENSVE)

NAME OF INSURED ZEESHAN ALI MUHAMMAD MUNIR POLICY NUMBER 1483123000

and/or EMIRATES NBD AXA POLICY REF. 13/VA/134883/0/2
ADDRESS P.O.Box 0 DXB DATE OF ISSUE 24/12/2019
DXB PREMIUM
COVER TYPE
UNITED ARAB EMIRATES
TPL PREMIUM AED 1,049.99
ACCOUNT NO 1792389/0
OWN DAMAGE PREMIUM AED 972.05
BUSINESS CODE 7072 / 2
ADDITIONAL COVERS PREMIUM AED 344.63
VAT @ 5.00% AED 118.33*
PREMIUM INCL. VAT AED 2,485.00
TOTAL PREMIUM AED 2,485.00

PERIOD OF INSURANCE FROM 18/01/2020 TO 24/01/2021 ( BOTH DAYS INCLUSIVE )

PARTICULARS OF INSURED VEHICLE(S) ‫ﺃﻭﺻﺎﻑ ﺍﻟﺴﻴﺎﺭﺓ ﺍﻟﻤﺆﻣﻨﺔ‬
‫ﺭﻗﻢ ﺍﻟﺘﺴﺠﻴﻞ‬ ‫ﺭﻗﻢ ﺍﻟﺸﺎﺳﻴﻪ‬ ‫ﺭﻗﻢ ﺍﻟﻤﺤﺮﻙ‬ ‫ﻗﻮﺓ ﺍﻟﻤﺤﺮﻙ ﺑﺎﻷﺣﺼﻨﺔ‬ ‫ﻟﻮﻥ ﺍﻟﺴﻴﺎﺭﺓ‬ ‫ ﺍﻟﻮﺯﻥ‬/ ‫ﺳﻌﺔ ﺍﻟﻤﺤﺮﻙ‬
Reg No Chassis No Engine No H Power Colour Engine Capacity/Tonage
1FM5K8D80HGA51978 HGA51978 RED 3500

‫ﺷﻜﻞ ﺍﻟﻬﻴﻜﻞ‬ ‫ﺍﻟﻐﺮﺽ ﻣﻦ ﺍﻟﺘﺮﺧﻴﺺ‬ ‫ﻧﻮﻉ ﺍﻟﺴﻴﺎﺭﺓ‬ ‫ﻟﻮﻥ ﺍﻟﻠﻮﺣﺔ‬ ‫ﺳﻨﺔ ﺍﻟﺼﻨﻊ‬ ‫ ﺍﻟﺴﺎﺋﻖ‬+ ‫ﻋﺪﺩ ﺍﻟﺮﻛﺎﺏ‬
Type of Use Make Plate Colour Year Seating Capacity
Body
4X4 Private use FORD EXPLORER WHITE 2017 1+6

INSURED'S VALUE OF THE VEHICLE : AED 99000 ‫ﻗﻴﻤﺔ ﺍﻟﻤﺮﻛﺒﺔ ﺍﻟﻤﺆﻣﻨﺔ‬

LIMIT OF LIABILITY : ‫ﺗﺤﺪﻳﺪ ﺍﻟﻤﺴﺆﻭﻟﻴﺔ‬
1. The maximum authorized repair limit as per the policy is: AED 1000 :‫ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﺘﻜﺎﻟﻴﻒ ﺍﻹﺻﻼﺡ ﺍﻟﻤﺼﺮﺡ ﺑﻬﺎ ﺩﻭﻥ ﺍﻟﺮﺟﻮﻉ ﻟﻠﺸﺮﻛﺔ ﺣﺴﺐ ﺍﻟﻮﺛﻴﻘﺔ ﻫﻲ‬-1
2. The company's maximum liability in respect of death or Unlimited ‫ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻷﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ‬- 2
bodily injury in respect of any one claim or series of claims ‫ ﻫﻲ ﻣﺎ ﻳﺤﻜﻢ ﺑﻪ ﻗﻀﺎﺋﻴﺎ ﻣﻦ ﺗﻌﻮﻳﺾ ﻣﻬﻤﺎ ﺑﻠﻐﺖ‬,‫ﻭﺍﺣﺪ ﻳﻨﺘﺞ ﻋﻨﻪ ﻭﻓﺎﺓ ﺃﻭ ﺇﺻﺎﺑﺔ ﺑﺪﻧﻴﺔ‬
resulting from one accident is the sum awarded by the
‫ﻗﻴﻤﺘﻪ‬
court whatever it may be.
3. The Company's maximum liability in respect of third AED 3,500,000 ‫ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻷﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ‬- 3
party property damage in respect of any one claim or :‫ﻭﺍﺣﺪ ﺗﺴﺒﺐ ﺑﺄﺿﺮﺍﺭ ﻣﺎﺩﻳﺔ ﻫﻮ‬
series of claims resulting from one accident is:
TERRITORIAL LIMITS : UAE and Oman if applicable - subject to collection of the Orange Card for Oman.
POLICY EXCESS AED 500 ‫ﺷﺮﻭﻁ ﺧﺎﺻﺔ‬
OPTIONAL COVERS

Hire car YES ‫ﺗﺄﺟﻴﺮ ﺍﻟﺴﻴﺎﺭﺓ‬

Breakdown Recovery YES ‫ﺗﻐﻄﻴﺔ ﺍﻟﻌﻄﻞ ﺍﻟﻤﻔﺎﺟﻰﺀ‬
PA Cover for Driver YES ‫ﺗﺄﻣﻴﻦ ﺍﻟﺴﺎﺋﻖ‬
PA Cover for Passenger YES ‫ﺗﺄﻣﻴﻦ ﺍﻟﺮﻛﺎﺏ‬
GCC Cover NO ‫ﺗﺄﻣﻴﻦ ﺩﺍﺧﻞ ﻣﺠﻠﺲ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﺨﻠﻴﺠﻲ‬

No Claims Discount 04 Years ‫ﺧﺼﻢ ﻟﻌﺪﻡ ﺣﺼﻮﻝ ﺣﺎﺩﺙ‬

Please refer to your policy booklet for full terms, limits, conditions and exclusions

Page 1 of 3
AXA VAT Registration Number 100291881900003 100291881900003 ‫ﺭﻗﻢ ﺗﺴﺠﻴﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﺍﻟﺨﺎﺻﺔ ﺑﺄﻛﺴﺎ‬
AXA Insurance (Gulf) BSC (c) P.O.Box 5862, Floor 39, Churchill Executive ‫ ﺍﻟﺨﻠﻴﺞ ﺍﻟﺘﺠﺎﺭﻱ‬,‫ ﺗﺸﺮﺷﻞ ﺍﻛﺴﻜﻴﻮﺗﻒ ﺗﺎﻭﺭ‬, ٣٩ ‫ﺍﻟﻄﺎﺑﻖ‬،٥٨٦٢:‫ﺏ‬.‫ )ﻡ( ﺹ‬.‫ﺏ‬.‫ﻡ‬.‫ ﺃﻛﺴﺎ ﻟﻠﺘﺄﻣﻴﻦ )ﺍﻟﺨﻠﻴﺞ( ﺵ‬,
Tower, Business Bay, Dubai, U.A.E ،‫ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ‬- ‫ﺩﺑﻲ‬
Telephone : 00971 (4) 4476111 ٠٠٩٧١ (٤) ٤٤٧٦١١١ : ‫ﻫﺎﺗﻒ‬
Email : Info.Dubai@axa-gulf.com Website : www.axa-gulf.com www.axa-gulf.com : ‫ ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬Info.Dubai@axa-gulf.com :‫ﺍﻟﺒﺮﻳﺪ ﺍﻻﻟﻜﺘﺮﻭﻧﻲ‬
Registered in the Insurance Companies Register - Certificate No. (69) dated 22/01/ 2002. Subject to the ‫ ﻓﻲ ﺷﺄﻥ ﺇﻧﺸﺎﺀ ﻫﻴﺌﺔ‬٢٠٠٧ ‫( ﻟﺴﻨﺔ‬٦)‫ ﺧﺎﺿﻌﺔ ﻷﺣﻜﺎﻡ ﻗﺎﻧﻮﻥ ﺭﻗﻢ‬.٢٠٠٢/٠١/٢٢ ‫( ﺑﺘﺎﺭﻳﺦ‬٦٩)‫ ﺷﻬﺎﺩﺓ ﺭﻗﻢ‬- ‫ﺷﺮﻛﺔ ﻣﺴﺠﻠﺔ ﻓﻲ ﺳﺠﻞ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﻴﻦ‬
provisions of Federal Law No. (6) of 2007 concerning the establishment of Insurance Authority and ، ‫ﺍﻟﺘﺄﻣﻴﻦ ﻭ ﺗﻨﻈﻴﻢ ﺃﻋﻤﺎﻟﻪ‬
Organization of its work Agents: The Kanoo Group ‫ﻣﺠﻤﻮﻋﺔ ﻛﺎﻧﻮ‬: ‫ﻭﻛﻼﺀ ﺍﻟﺘﺄﻣﻴﻦ‬
 RENEWAL SCHEDULE - MOTOR PERFECT (COMPREHENSVE)

‫ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ ﻭﺳﻠﻄﻨﺔ ﻋﻤﺎﻥ ﺑﺸﺮﻁ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺑﻄﺎﻕ‬

Agency Repairs YES ‫ﺗﺼﻠﻴﺢ ﺩﺍﺧﻞ ﺍﻟﻮﻛﺎﻟﺔ‬

Mortgage Clause
Bank Name : EMIRATES NBD
Mortgage clause: It is hereby declared and agreed that 1. Notwithstanding anything herein to the contrary, the interest of the
above Bank is named in the Policy as Joint Insured and shall be limited to the following provisions of the clause. 2. Upon any
money becoming payable under this policy, the same shall be paid by the Company to the above Bank and such other part of
any monies so paid as may relate to the interest of other parties insured hereunder shall be received by the Bank as Agent for
other such parties. 3. The receipt of the Bank shall be a complete discharge to the Company and shall be binding on all parties
insured hereunder. 4. That if and whenever any notice shall be required to be given or other communications shall be required
to the made by the company to the insured in any matter arising under or in connection with this policy, such notice or other
communication shall be deemed to have been sufficiently given or made as if given or made to the bank. 5. That the due
observance and fulfillment of the terms of the policy by the insured in so far as they relate to anything to be done or complied
with by them shall be condition precedent to any liability of the company to make payment under this clause. 6. Further to the
above, we additionally confirm the following: a) The above Bank is named as assignee/beneficiary under the above policy. b)
We have received full premium for the tenor mentioned in the policy. c) The policy will not be cancelled during the validity of its
tenor without your written consent (Subject to the terms, exceptions and conditions of the policy).
Young Driver Excess
Young/Novice driver excess: If at the time of an accident, the vehicle is found to have been driven by anyone under 25 years
of age (completed age) and/or with less than 12 months valid UAE license (other than transferable license) then, the Insured
shall bear 10% of the claim, in addition to the normal policy excess.
Racing Exclusion clause
Racing exclusion clause: Policy excludes liability arising out of usage of vehicle against racing, rallies and/or speed trials.
Ambulance Services
Ambulance Services: If at the time and due to a road traffic accident caused by our insured (You), an ambulance to transfer
the injured person / people to the hospital is required, the company shall pay for the cost of the Ambulance Services up to the
amount of AED 6770 paid directly to the provider.
Applicable Taxes
Applicable Taxes:You accept and agree to pay any taxes on this Policy, in compliance with the laws and regulations applicable
in the territory of sale, including but not limited to value added tax VAT, which are due on Your Policy, within fifteen working
days from the date of request to pay by AXA. AXA will contact you in the event that VAT is applicable to Your Policy. Failure
by You to pay any applicable taxes may result in Your Policy being rendered null and void or cancelled at AXA"s discretion

Disclaimer
Please refer to your policy terms and conditions and your new schedule for your full product details. Due to recent changes in UAE Motor
Insurance regulations, your policy may have changed, including, but not limited to, your excess, cover limits and exclusions. Please call
us if you need any further clarification.

December , 24 , 2019 Noura

/13DN02814768

Page 2 of 3
AXA VAT Registration Number 100291881900003 100291881900003 ‫ﺭﻗﻢ ﺗﺴﺠﻴﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﺍﻟﺨﺎﺻﺔ ﺑﺄﻛﺴﺎ‬
AXA Insurance (Gulf) BSC (c) P.O.Box 5862, Floor 39, Churchill Executive ‫ ﺍﻟﺨﻠﻴﺞ ﺍﻟﺘﺠﺎﺭﻱ‬,‫ ﺗﺸﺮﺷﻞ ﺍﻛﺴﻜﻴﻮﺗﻒ ﺗﺎﻭﺭ‬, ٣٩ ‫ﺍﻟﻄﺎﺑﻖ‬،٥٨٦٢:‫ﺏ‬.‫ )ﻡ( ﺹ‬.‫ﺏ‬.‫ﻡ‬.‫ ﺃﻛﺴﺎ ﻟﻠﺘﺄﻣﻴﻦ )ﺍﻟﺨﻠﻴﺞ( ﺵ‬,
Tower, Business Bay, Dubai, U.A.E ،‫ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ‬- ‫ﺩﺑﻲ‬
Telephone : 00971 (4) 4476111 ٠٠٩٧١ (٤) ٤٤٧٦١١١ : ‫ﻫﺎﺗﻒ‬
Email : Info.Dubai@axa-gulf.com Website : www.axa-gulf.com www.axa-gulf.com : ‫ ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬Info.Dubai@axa-gulf.com :‫ﺍﻟﺒﺮﻳﺪ ﺍﻻﻟﻜﺘﺮﻭﻧﻲ‬
Registered in the Insurance Companies Register - Certificate No. (69) dated 22/01/ 2002. Subject to the ‫ ﻓﻲ ﺷﺄﻥ ﺇﻧﺸﺎﺀ ﻫﻴﺌﺔ‬٢٠٠٧ ‫( ﻟﺴﻨﺔ‬٦)‫ ﺧﺎﺿﻌﺔ ﻷﺣﻜﺎﻡ ﻗﺎﻧﻮﻥ ﺭﻗﻢ‬.٢٠٠٢/٠١/٢٢ ‫( ﺑﺘﺎﺭﻳﺦ‬٦٩)‫ ﺷﻬﺎﺩﺓ ﺭﻗﻢ‬- ‫ﺷﺮﻛﺔ ﻣﺴﺠﻠﺔ ﻓﻲ ﺳﺠﻞ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﻴﻦ‬
provisions of Federal Law No. (6) of 2007 concerning the establishment of Insurance Authority and ، ‫ﺍﻟﺘﺄﻣﻴﻦ ﻭ ﺗﻨﻈﻴﻢ ﺃﻋﻤﺎﻟﻪ‬
Organization of its work Agents: The Kanoo Group ‫ﻣﺠﻤﻮﻋﺔ ﻛﺎﻧﻮ‬: ‫ﻭﻛﻼﺀ ﺍﻟﺘﺄﻣﻴﻦ‬
 RENEWAL SCHEDULE - MOTOR PERFECT (COMPREHENSVE)

Signed on behalf of the company on :

ATTORNEY (S)

Page 3 of 3
AXA VAT Registration Number 100291881900003 100291881900003 ‫ﺭﻗﻢ ﺗﺴﺠﻴﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﺍﻟﺨﺎﺻﺔ ﺑﺄﻛﺴﺎ‬
AXA Insurance (Gulf) BSC (c) P.O.Box 5862, Floor 39, Churchill Executive ‫ ﺍﻟﺨﻠﻴﺞ ﺍﻟﺘﺠﺎﺭﻱ‬,‫ ﺗﺸﺮﺷﻞ ﺍﻛﺴﻜﻴﻮﺗﻒ ﺗﺎﻭﺭ‬, ٣٩ ‫ﺍﻟﻄﺎﺑﻖ‬،٥٨٦٢:‫ﺏ‬.‫ )ﻡ( ﺹ‬.‫ﺏ‬.‫ﻡ‬.‫ ﺃﻛﺴﺎ ﻟﻠﺘﺄﻣﻴﻦ )ﺍﻟﺨﻠﻴﺞ( ﺵ‬,
Tower, Business Bay, Dubai, U.A.E ،‫ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ‬- ‫ﺩﺑﻲ‬
Telephone : 00971 (4) 4476111 ٠٠٩٧١ (٤) ٤٤٧٦١١١ : ‫ﻫﺎﺗﻒ‬
Email : Info.Dubai@axa-gulf.com Website : www.axa-gulf.com www.axa-gulf.com : ‫ ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬Info.Dubai@axa-gulf.com :‫ﺍﻟﺒﺮﻳﺪ ﺍﻻﻟﻜﺘﺮﻭﻧﻲ‬
Registered in the Insurance Companies Register - Certificate No. (69) dated 22/01/ 2002. Subject to the ‫ ﻓﻲ ﺷﺄﻥ ﺇﻧﺸﺎﺀ ﻫﻴﺌﺔ‬٢٠٠٧ ‫( ﻟﺴﻨﺔ‬٦)‫ ﺧﺎﺿﻌﺔ ﻷﺣﻜﺎﻡ ﻗﺎﻧﻮﻥ ﺭﻗﻢ‬.٢٠٠٢/٠١/٢٢ ‫( ﺑﺘﺎﺭﻳﺦ‬٦٩)‫ ﺷﻬﺎﺩﺓ ﺭﻗﻢ‬- ‫ﺷﺮﻛﺔ ﻣﺴﺠﻠﺔ ﻓﻲ ﺳﺠﻞ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﻴﻦ‬
provisions of Federal Law No. (6) of 2007 concerning the establishment of Insurance Authority and ، ‫ﺍﻟﺘﺄﻣﻴﻦ ﻭ ﺗﻨﻈﻴﻢ ﺃﻋﻤﺎﻟﻪ‬
Organization of its work Agents: The Kanoo Group ‫ﻣﺠﻤﻮﻋﺔ ﻛﺎﻧﻮ‬: ‫ﻭﻛﻼﺀ ﺍﻟﺘﺄﻣﻴﻦ‬