reliancegeneral.co.in Boe (Toll Free) 1800 3009 Sey (022) 4890 3009 GENERAL INSURANCE Reliance Commercial Vehicles (GCV Other than 3 Wheelers Public) Package Policy- Schedule oor. rect ae RAIGARH, MAHARASHTRA, DADAR WEST MUMBAI MAHARASHTRA 400028 Feat i fee oie saa enna aa geomiiebee Sor Engine No. /Chassis No. 276307™A01007 LCC Induding Driver 3 oe emer = —— ae wi "Own Damage - Section | ‘Amount (2) Liability - Section ‘Amount (®) Basic 00 (8804.40 Basic Labilty (TPPD 1) 42037.00 Covers fr Lampe Tyres/Tubes MusguardeBoneUSide Total Basic Liability Premium 43037.00 pare ete (MT-23), 103418 PA Benefits - Section it Total Basic Own Damage Premium 7928.56 Lega Liab to paid ever andor Conductor Less: andor deaner 100.00 Deduct 45% for NCB 3567.85 TOTAL LIABILITY PREMIUM 43197.00 ‘Sub Total of Deductions 3567.85 TOTAL PACKAGE PREMIUM (Sec ++I) 47498.00 TOTAL OWN DAMAGE PREMIUM {4380.71 CGST on 00 Premium (@9.00%) 401.00, 'SGST on OD Premium (@9.00 %) 401.00 LGGST on TP Premium (5.00%) ae 'SGST on TP Premium (6.00%) ‘Subject to LMT.Endt Nos. & Memorandum printc/herei/attached hereto MT 40.23 21,7 [GSTIN Z7AABCRBTATBIZG HSN: 9971 [Beecipion of sevsces "Motor Verte inaurance services Consolidated Stamp dty Paid vide Letter of Authorisation No. CSOV221/205GI5504 dated 18h Nov 2010" Not Rpiiabl forthe State of J8K 13BRG4D5 / D2c Insurance Broking Put Ltd 1900419785 yp.correction@renewbuy.com Titermediary CodeIName Intermediary Contact No. Intermediary Email Paget