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Bajaj Allianz General Insurance Company LTD
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
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 Kilowatt
DL3CBM445 JAN-2010 FIAT LINEA ACTIVE DIESEL 1248 2010 5
3 (DIESEL)
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.)
47193 48LPZ 0 0 0 0 0
C. Coverage opted
Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons,
etc; Golden Heights,4th Floor,, No.1/2,59th C Cross, 4th M Block,Rajajinagar, , BANGALORE-560010 Phone No :080-67195000
Policy Number OG-21-1701-1805-00015237 Product Liability Only Policy For Private Car
Period Of Insurance From: 04-Mar-2021 Policy issued on 02-Mar-2021 -
To: 03-Mar-2022 Midnight Cover Note No /
Application No Scrutiny No 251366054
Insured Name PRANAV SHARMA Zone A
Insured Address , , ,, NEEMRANA - 301705
Customer ID 208909964 Premium Payer ID 208909964
Transaction Id
Policy Status ISSUED
GSTIN / UIN NA Place of Supply/State 08 - Rajasthan
Code/Name
Invoice No. 252579512/1
Company GST No 29AABCB5730G1ZT
Company PAN No AABCB5730G
Registration Make SubType Model CC/KW Mfg year Seat Cap Vehicle/ Engine Number
No. Trailer
Chassis
No
DL3CBM4453 FIAT ACTIVE LINEA 1248 2010 5 48LPZ 47193
(DIESEL)
Fuel Type Vehicle IDV Elec Acc Non Elec Acc Trailer Trailer Reg No CNG/LPG Unit Total Sum Insured
DIESEL 0 0 0 0 0
SCHEDULE OF PREMIUM
OWN DAMAGE LIABILITY
Total Own Damage Premium: Basic Third Party Liability 3,221.00
PA Cover For Owner-Driver - SI - Rs. 331.00
15,00,000.00
Total Liability Premium: 3,552.00
Additional loading @ 0% 0
In case of any claim, please contact our 24 Hour Call centre at 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'.
251366054/-/10077709/0/-
Regd. Office : Bajaj Allianz House, 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.Principal Location : Golden Heights,
4th Floor, No.1/2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010 PH:080-67195000 | Services Accounting Code : 997134 - Motor vehicle insurance ser-
vices. No reverse charge is payable on these services. - Latest Schedule - 02-Mar-2021 19:01:20 PM (Web)
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 This document is digitally signed, hence counter signature / stamp is not required
Printed , Signed and Executed at Pune
Regd Office : Bajaj Allianz House,Airport Road, Yerwada Pune-411006 (India), A Company incorporated under Indian Companies Act, 1956 and licensed by In-
surance Regulatory and Development Authority of India [IRDA] vide Reg No.113, Corporate Identification Number U66010PN2000PLC015329.
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No. MH010174751202021M Defaced No. 0004860541202021 dated 25-JAN-21
timing 17:39:54 of General Stamp Office,Mumbai,India.
Generated by Silent_Printing
Regd. Office : Bajaj Allianz House, 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.Principal Location : Golden Heights,
4th Floor, No.1/2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010 PH:080-67195000 | Services Accounting Code : 997134 - Motor vehicle insurance ser-
vices. No reverse charge is payable on these services. - Latest Schedule - 02-Mar-2021 19:01:20 PM (Web)
Bajaj Allianz General Insurance Company Ltd.
Golden Heights, 4th Floor, No.1/2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010
Contact No:Contact No: 080-67195000,67195001/67195002
RECEIPT
Authorised Signatory