BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED: coord ti Como a ea Hy me vpn Ato Regd, Ofc: Baja) Alla House, Airport Road, Verwads,Pne-1006(Inda)) pole suing office and Correspondence address for communication by policyholder for claim, service request, notice, summons tes ole BAT Square, 168, ott Floor, Man Square, 64, Canal Cirle road, Mani Sguare Premuses,, KOLKATA. 70054 PHL33-50212900 fi INSURED DETAILS Tnsured Name | GOBINDA SINGH ~_|83/B, DHARMATALA ROAD, BUDGE Jnswred | BUDGE , BUDGE BUDGE NATUN BAZAR, SOUTH 24 PARGANAS, WEST Address POLICY DETAILS ‘0G-24-2401-1826-00020081 03-AUG-2023 18:04 PM For Own Damage Section _| From : 03-AUG-2023 18:03 (Hrs) ee | To: 02-AUG-2024 Midnight For Third Party Liability Section From : 03-AUG-2023 1803 (Hrs) To. 02-AUG-2028 Midnight 19- West Bengal - = — "| BENGAL 700137 3864009001 comes 19AABCBS730G12U AABCBS7306 Registration MEHKISCFPDO2 |HONDA - AC. NEw ALIPORE JKISED 7043364 Be Da j NBe | ‘ 0 125 2 2023 i IDFC FIRST BANK LTD 4 ve 85,406.00 0 0 0 0 85,406.00 : Own Damage Premium 501.00/ Basic Party Liability: 3,851.00, Special Discount TPA Cover for Owner: Driver ST-RSTS00000, | 331.00 : Total OD Premiun= A SOT OU Period: Feom 03-Aug-2023 To 02-AUG-2024 Tal Prim (Net Premium) (AFB) 4,683.00 Total Aet Premium -B 182.00 Slate GST (9%) Central GST (0%) al Premium | Rupees Five Thousand Five Mun Only) sbove Tea OD Prema asa al apple Losing reco i (Ana A Teh Hanh Peon, Diver Tuo, Fer Gls CNGALPG Unit Gopal Estesion lps Vehise Fe wherever Apple) ‘As perth OST regulations, the amount of GST will not be refunded if he ply! endorsement ie caneted after 30h September ofthe next anc ye eps ee tm ‘nat 3 CCH 2-88 10H, es OIE eg a once nombre mala) aot Bo apne Mere mains {aren Montes Laamaer cots» outed eM