CONFIRMATION OF PURCHASE OF INSURANCE

E-C/Note No : D16677-23000538
Issue Date & Time : 24 MAR 2023 10:40:55am
Period of Cover : From 24 MAR 2023 To 23 MAR 2024
Vehicle Registration No. : BMC1089
Make of Vehicle : PROTON PREVE PREMIUM 7 SP AUTO PROTONIC
Engine No. : S4PHTL0356 Chassis No. : PL1CR6SDRDG031245
Capacity : 1561 CC Year of Make : 2013
Insured Name : FAIZAL BIN MOKHTAR
Address : 22-23,PLATINUM RESIDENSI TERATAI,NO.2 JALAN KURAMAN,53000 SETAPAK,KUALA
LUMPUR,53000,KUALA LUMPUR,KUALA LUMPUR (WP)
NRIC/Business Reg No. : 780115-14-6369
Type of Cover : V-CO MOTOR COMPREHENSIVE
Product : PRIVATE CAR - Z-DRIVER
HP Owner : N/A
Sum Insured (RM) : 18,000
Transaction Type : New
Claims Excess : RM 0.00
Voluntary Excess : RM 0.00

Sum Insured (RM) 18,000 Premium (RM) 649.50

NCD % 45.00 % NCD Amt (RM) 292.28

Voluntary Excess (RM) (0.00)

Basic Net (RM) 357.22

Extra Coverage (RM) 20.00

SST 6.00 % SST (RM) 22.63
Stamp Duty (RM) 10.00
PT Voucher (RM) 0.00

Act Premium (RM) 89.31 Payable Premium (RM) 409.85

Extra Benefits Extra Sum Ins (RM) Extra Premium (RM)

AUTHORISED DRIVER 0 20.00
WINDSCREEN,WINDOWS REPAIR (Non-Tariff)(subject to excess) 200 0.00

Named Drivers
ALL DRIVERS

Agent : D16677-000 QOALA TECHNOLOGY SDN BHD

Tel No : 011-54232787
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THIS IS A COMPUTER GENERATED FORM, SIGNATURE IS NOT REQUIRED.
ZURICH ROADSIDE ASSISTANCE
24 Hours HOTLINE Number: - 1300 88 6222
These value-added benefits entitle you to Roadside Assistance program twenty -four (24) hours a day, three hundred sixty-five (365) days a year,
anywhere in Malaysia only. The services will only be rendered to the Registered Vehicle in the event of breakdown during the period of Insurance. The
Insured/driver of the Registered Vehicle must call the 24-Hour HOTLINE number 1300-88-6222 to request for the services below.
(a) Minor Roadside Breakdown
In the event that the Registered Vehicle is immobilized due to breakdown, you shall contact 24-Hours Hotline for assistance. Should it be deemed possible
to repair the Registered Vehicle on the spot, We shall arrange for such minor roadside repair. In the event it is not possible to repair the car on site ,
paragraph (b) shall be applicable. We shall organize and pay for labour cost for roadside repair up to a maximum labour of One hour (1) per event. We
shall not be responsible for any cost incurred for spare parts required during the Minor Roadside Repairs. We shall not be responsible to ensure the
authenticity or genuine parts are used by the workshop or repairer.
(b) 24-Hour Emergency Towing
If your car breakdown and it is not possible to repair the car on the site, we shall assist to tow the car to Your preferred workshop. Additional cost of
towing is approximately RM2.00 per km (round-trip) shall be borne and paid by the Insured /driver, and the cost of towing may vary according to prevailing
market rates applicable to Private Car Comprehensive only). Toll charges shall be borne by the You. The twenty -four (24) hours emergency towing
services shall be made available in the event the Registered Vehicle is immobilized anywhere in Peninsular Malaysia excluding islands except for Penang
and on the Island of Langkawi. In East Malaysia, the towing service shall only be available at major towns and on the island of Labuan.
Private Car
Breakdown Towing Limits (KM)
Comprehensive Only Z Drive Assist with/without Private Car policy
New Policy 150 KM Unlimited
Renewal Policy 300 KM Unlimited

Limitations and Exclusion of Service

We shall not be liable or to provide the services under paragraph (a) and (b) above under the following circumstances:
1. Services which are not organized or pre-approved directly by Us.
2. Towing in the event of an accident.
3. If the Registered Vehicle is or has been modified for participation in legitimate or illegitimate rally and racing or modified against government regulations .
4. Service provision outside the territorial limits stated.
5. Failure of the Insured/driver and/or passenger(s) of the Registered Vehicle to take reasonable precautions or to follow warnings of any intended strike ,
riot or civil commotion via the mass media.
6. Any commercial vehicle or vehicles not registered to receive this Services.
7. If your vehicle is registered as A and C Permit vehicle .
8. When the car keys are not available or locked inside the Registered Vehicle .
9. When there is no mechanical part in the Registered Vehicle , such as no engine or transmission.
10. Towing of a Registered Vehicle for the purpose of disposing the vehicle .
11. Towing of a Registered Vehicle for the purpose of transferring the vehicle from one workshop to another .
12. No valid road tax disc displayed on the Registered Vehicle .
13. Towing a stolen Registered Vehicle which has been discovered , abandoned or due to vandalism.
14. Registered Vehicle that has been dismantled fully or partly in a workshop with or without the consent of the Insured / driver.
15. Towing a Registered Vehicle that is greater weight than for which it was designed as stated in the manufacturer 's specifications.
16. Towing a Registered Vehicle which registration number does not match with the number registered with Us .
17. Towing a Registered Vehicle due to catastrophe events or Act of God such as earthquake , landslip, landslide or other convulsion of nature is involved.
18. If the Registered Vehicle suffers a mechanical breakdown and is immobilized on an unpaved road surface or on a road that is not a gazette road .
19. If the Registered Vehicle requires the use of special equipment during the roadside repair or towing process .
20. Transportation for the Registered Vehicle's driver to the vehicle for service or from the vehicle to another destination after service has been rendered.
21. Towing at the direction of a law enforcement office related to traffic obstruction , impoundment, abandonment, illegal parking or other violations of the law.
22. Any cost on parts and cost of repair at the workshop or service centre.

We shall not be responsible to render the service or to bear any costs and expenses in respect of or under the following circumstances:

1. Services not organized directly by the us.

2. Service outside the territorial limits stated.
3. Cost of repair or replacement of parts.
4. Petrol, parking fees, accommodation and telephone charges.
5. When the car keys are not available or locked inside Your Car .
6. When Your Car do not have an engine or mechanical parts .
7. When towing is for the reason to dispose Your Car .
8. Towing for discovered stolen of Your Car or abandoned vehicle .
9. When towing is for a reason of transferring Your Car from one workshop to another workshop .
10. When there is no valid road tax disc displayed on Your Car .
11. Tow Your Car after it has been sent for a spray job .
12. If Your Car is or has been modified for participation in rally or racing , or if the Your Car has been modified against government regulations .
13. Failure of the Insured to take reasonable precautions or to follow warnings of any intended strike, riot or civil commotion via the mass media.
14. Any illegal or unlawful act by You or the use of Your Car for any unlawful or illegal purposes .
15. Towing or repair of any motorcycles and commercial Named Vehicles such as but not limited to lorries , trucks, wagons, taxis etc.
We reserve the right to refuse assisting and towing of such vehicles .
16. When special towing and/or special equipment is required during the course of providing the towing services for Your Car which , in the sole opinion
of the Company, are considered high risk and/or reasonably impracticable. For example, when the car or car tyre fall into the drain or river.
17. When Your Car is on an unpaved road surface or on a road that is not a gazette road of the road systems of Malaysia .
18. When Your Car can still be driven.
19. When the breakdown of Your Car is due to forget to fill up fuel or pumped in wrong fuel to Your Car .
20. When second towing of Your Car is requested for one same incident .
 PRIVATE CAR
KERETA PERSENDIRIAN
THE SCHEDULE JADUAL
ORIGINAL COPY SALINAN ASAL

Agent Code (Kod Ejen) : D16677-000 (PARTNERSHIP & AFFINITY) Date (Tarikh) : 24 MAR 2023
QOALA TECHNOLOGY SDN BHD Receipt No. :
(No. Resit)
Replacing Cover Note No. : D16677-23000538
(Menggantikan Nota Lindung No.) ACT (ACT) : RM 89.31
Policy No. (No. Polisi) : 352300000788-00 Basic Premium : RM 649.50
The PolicyHolder : FAIZAL BIN MOKHTAR
(Yang Diinsuranskan)

Address (Alamat) : 22-23,PLATINUM RESIDENSI TERATAI, NO.2 JALAN

KURAMAN,53000 SETAPAK,KUALA LUMPUR NCD:45.00% : RM 292.28
53000 KUALA LUMPUR, KUALA LUMPUR (WP)
Less: Voluntary Excess : RM 0.00
Business Reg. No. (No. Sykt.) : Extra Cover : RM 20.00
I/C No. New (No. K/P Baru) : 780115-14-6369 Old I/C No.(No. K/P Lama) :
Gross Premium : RM 377.22
Business / Profession (Perniagaan / Pekerjaan) : OFFICE WORKERS
Hire Purchase Owners (Pemilik Sewa Beli ) : N/A SST: 6.00% : RM 22.63
Employer / Lessors (Majikan / Pemajak) : Stamp Duty
(DUTI SETEM) : RM 10.00
Period of Insurance (a) From (Dari) : 24 MAR 2023 To (Hingga) : 23 MAR 2024 Termasuk kedua-dua
(Tempoh Insurans)
Time(Masa) : 10:40AM To(Hingga) : 11.59PM tarikh dan masa
Total Premium : RM 409.85
(b) Any subsequent period for which you shall pay and we shall (JUMLAH)
agree to accept a renewal premium
Sebarang tempoh selanjutnya untuk mana anda membayar dan kami bersetuju
menerima premium pembaharuan
The Motor Vehicle Any of the following (Mana - mana daripada yang berikut): Kenderaan Motor
Registration No. Make Type of Body Cubic Capacity Year of Seating Capacity Your Estimate of Value
Manufacture Including Driver Including Accessories
No. Pendaftaran Buatan Jenis Badan Keupayaan Enjin Tahun Diperbuat Muatan Tempat Duduk Nilai Anggaran Anda
termasuk Pemandu termasuk Aksesori
BMC1089 PROTON 4D 1561 CC 2013 5 RM18,000
PREVE PREMIUM SEDAN

Date of Signature of Proposal and Declaration Claims Excess : RM 0.00 Engine (Enjin) : S4PHTL0356
Tarikh Cadangan dan Perakuan Ditandatangan (Ekses Tuntutan) Chassis (Casis) : PL1CR6SDRDG031245
Subject to the terms and conditions of the Policy and endorsement as numbered below :
Tertakluk kepada peraturan - peraturan dan syarat - syarat Polisi dan pengendorsan seperti disenaraikan di bawah :

Named Driver : 1) ALL DRIVERS

Additional Extra Coverage/Endorsements :-

Code Description Sum Insured Premium
01A AUTHORISED DRIVER : 1 0 20.00
263 WINDSCREEN,WINDOWS REPAIR (Non-Tariff)(subject to excess) : 1 200 0.00
Excess (Ekses)
Excess is the first amount that you are required to pay towards a claim you make on your vehicle. Claims excess is the amount of excess determined
by Company based on your risk profile. Voluntary Excess is the amount of excess that is chosen by you in return for a lower premium. In addition ,
Compulsory Excess may apply depending on the circumstances defined in the policy.

Ekses adalah amaun pertama yang Anda perlu tanggung bagi setiap tuntutan yang dibuat. Ekses Tuntutan adalah ekses yang ditentukan oleh Syarikat
berdasarkan profil risiko Anda. Ekses Sukarela adalah ekses amaun yang dipilih oleh Anda sebagai balasan premium polisi dikurangkan. Di samping itu ,
terdapat Ekses Wajib di mana Anda perlu tanggung seperti yang dinyatakan di dalam polisi ini .

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LEGISLATION:-
Road Transport Act, 1987 (Malaysia) Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore Motor Vehicles (Third Party Risks and
Compensation) Rules (Republic of Singapore) Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam (the reference to legislation under the
heading "Avoidance of Certain Terms and Right of Recovery" is limited to Section 94, 95 and 96 of the Road Transport Act 1987 (Malaysia) Section 7, 8 and 9 of the Motor
Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore and Section 7 of the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara
Brunei Darussalam.
UNDANG - UNDANG:-
Akta Pengangkutan Jalan Raya, 1987 Malaysia, Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapore, Peraturan Kenderaan Motor
(Risiko Dan Pampasan Pihak Ketiga) 1960 Republik Singapura, Akta Insurans Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam (rujukan kepada
undang - undang di bawah tajuk "Pengelakan Peraturan - Peraturan Dan Hak Tuntutan Tertentu" adalah terhad kepada Seksyen 94, 95 dan 96 Akta Pengangkutan Jalan
Raya, 1987 Malaysia. Seksyen 7, 8 dan 9 Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapura, dan Seksyen 7 Akta Insurans
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam).

Limits of Liability:-
Had Tanggungan:

Limit of the amount of Our Liability under Section B-1(a) .......... Unlimited For and on behalf of / Untuk dan bagi pihak
Had jumlah tanggungan Kami di bawah Seksyen B-1(a) .......... Zurich General Insurance Malaysia Berhad
Limit of the amount of Our Liability under Section B-1(b) .......... RM3,000,000.00
Had jumlah tanggungan Kami di bawah Seksyen B-1(b) ..........

Limitation as to Use : As shown in the Certificate of Insurance

Had Penggunaan : Seperti ditunjukkan dalam Sijil Insurans
Geographical Area : Malaysia, Republic of Singapore and Negara Brunei Darussalam
Had Wilayah : Malaysia, Republik Singapura dan Negara Brunei Darussalam
Authorised Driver : As shown in the Certificate of Insurance
Junior Cho
Pemandu Yang Dibenarkan
: Seperti ditunjukkan dalam Sijil Insurans Chief Executive Officer

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 Code / Kod 18 MX1
CERTIFICATE OF INSURANCE SIJIL INSURANS
ROAD TRANSPORT ACT, 1987 (MALAYSIA) AKTA PENGANGKUTAN JALAN RAYA, 1987 (MALAYSIA)
THE MOTOR VEHICLES (THIRD PARTY RISKS, RULES 1959 (MALAYSIA) PERATURAN KENDERAAN MOTOR (RISIKO PIHAK KETIGA) 1959 (MALAYSIA)
THE MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) ACT AKTA KENDERAAN MOTOR (RISIKO DAN PAMPASAN PIHAK KETIGA) (CAP 189) (REPUBLIK SINGAPURA)
(CAP 189) (REPUBLIC OF SINGAPORE) PERATURAN KENDERAAN MOTOR (RISIKO DAN PAMPASAN PIHAK KETIGA) 1960 (REPUBLIK
THE MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) RULES 1960 (REPUBLIC OF SINGAPURA),
SINGAPORE) AKTA INSURANS KENDERAAN MOTOR (RISIKO PIHAK KETIGA) (CAP 90) NEGARA BRUNEI
THE MOTOR VEHICLES INSURANCE (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM DARUSSALAM

Certificate No. (No. Sijil) : 352300000788-00 D16677-000

1. Index Mark and Registration Number of Vehicle : BMC1089 NCD : 45.00 %

(Tanda Indeks dan Nombor Pendaftaran Kenderaan) : PROTON PREVE PREMIUM 7 SP AUTO PROTONIC
2. Name of PolicyHolder (Nama Pemegang Polisi) : FAIZAL BIN MOKHTAR
3. Effective date of the Commencement of Insurance for the purposes of the Regulations, Ordinance of 24 MAR 2023
Enactment :
4. Date of Expiry of the Insurance (Tarikh Insurans Tamat) : 23 MAR 2024
5. Persons or Classes of Persons entitled to drive* (Orang atau Kelas Orang yang berhak memandu*) :

a) Policyholder b) Any other person who is driving on the Policyholder's order or with his permission.
Provided that the person driving is permitted in accordance with the licensing or other laws or regulations to
drive the Motor Vehicle or has been so permitted and is not disqualified by order of a Court of Law or by
reason of any enactment or regulation in that behalf from driving the Motor Vehicle.

Limitation on Usage
Use only for social, domestic and pleasure purposes and for the policyholder's business or profession. The
policy does not cover :- Use for hire or reward, racing, pace-making, reliability trial, speed- testing, or
the carriage of goods (other than samples) in connection with any trade or business or use for any purpose in
connection with Motor Trade.

* Limitations rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore or Section 7
of the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam are not to be included under these heading.

* Had - had yang tidak lagi berkuatkuasa kerana Seksyen 95 Akta Pengangkutan Jalan Raya, 1987 (Malaysia) atau Sekyen 8 Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189)
Republik Singapura atau Seksyen 7 Akta Insurans Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam tidak boleh dimasukkan di bawah tajuk ini.

Insured in pursuance to cover Note No : D16677-23000538

Dikeluarkan mengikut Nota lindungan No :

I / We hereby certify that the Policy to which the Certificate is issued in accordance For and on behalf of / Untuk dan bagi pihak
with the provisions of Part IV of the Road Transport Act, 1987 (Malaysia), Motor ZURICH GENERAL INSURANCE MALAYSIA BERHAD
Vehicles (Third Party Risks & Compensation) Act (Cap 189) Republic of Singapore
and the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei
Darussalam.

Saya / Kami dengan ini mengesahkan bahawa Polisi yang berkaitan dengan Sijil
ini dikeluarkan selaras dengan peruntukan - peruntukan Bahagian IV Akta
Pengankutan Jalan Raya, 1987 (Malaysia), Akta Kenderaan Motor (Risiko Dan Junior Cho
Pampasan Pihak Ketiga) (Cap 189) Republik Singapura dan Akta Insurans Chief Executive Officer
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam
Page 3 of 4
CERTIFICATE OF INSURANCE

This Certificate is not transferable to a new owner of the Vehicle .

If for any reason the Insurance is terminated during its currency this Certificate must be returned to the Company or if this Certificate has been
lost or destroyed a Statutory Declaration to that Effect must be made . Failure to comply with this obligation is an offence under the compulsory
Insurance Legislation.

This Certificate must be returned if the Insurance is suspended during its currency.

SIJIL INSURANS

Sijil ini tidak boleh dipindahkan kepada pemilik baru Kenderaan.

Jika atas sebarang sebab Insurans ini ditamatkan semasa ia masih berkuatkuasa Sijil ini mesti dipulangkan kepada Syarikat atau jika Sijil ini
telah hilang atau dimusnahkan, satu Pengakuan Berkanun menyatakan demikian mesti dibuat. Kegagalan untuk mematuhi kewajipan ini
adalah satu kesalahan di bawah Undang - Undang Insurans wajib.

Sijil ini mesti dipulangkan jika Insurans digantung semasa ia masih berkuatkuasa.

IMPORTANT NOTICE
If you are involved in an accident causing injury to any person or damage to any property or other vehicle you must :
(a) Try to obtain names and address of any witness to the accident.
(b) Report to the Company immediately.
(c) Refer to the Company immediately all communications received from the Police Authorities.
(d) Send to the Company immediately all letters from Third Parties unanswered.
(e) Not to pay money to any Party involved in the accident without the Company's written permission.

NOTIS PENTING
Sekiranya anda terlibat di dalam sebarang kemalangan yang menyebabkan kecacatan kepada sesiapa atau kerosakan
kepada sebarang harta benda atau sebarang kereta anda mesti :
(a) Cuba mendapatkan saksi-saksi kepada kemalangan itu.
(b) Melaporkan kepada Syarikat dengan segera.
(c) Merujuk kepada Syarikat dengan segera segala perhubungan yang diterima daripada pihak berkuasa Polis.
(d) Mengirimkan kepada Syarikat dengan segera semua surat - surat yang diterima dari pihak - pihak lain tanpa berjawab.
(e) Jangan membayar wang kepada sebarang pihak yang terlibat di dalam kemalangan itu tanpa mendapat kebenaran
bertulis dari Syarikat ini.

I / We hereby certify that the Policy to which the Certificate is issued in accordance
For and on behalf of / Untuk dan bagi pihak
with the provisions of Part IV of the Road Transport Act, 1987 (Malaysia), Motor
ZURICH GENERAL INSURANCE MALAYSIA BERHAD
Vehicles (Third Party Risks & Compensation) Act (Cap 189) Republic of Singapore
and the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei
Darussalam.

Saya / Kami dengan ini mengesahkan bahawa Polisi yang berkaitan dengan Sijil
ini dikeluarkan selaras dengan peruntukan - peruntukan Bahagian IV Akta
Pengankutan Jalan Raya, 1987 (Malaysia), Akta Kenderaan Motor (Risiko Dan Junior Cho
Pampasan Pihak Ketiga) (Cap 189) Republik Singapura dan Akta Insurans Chief Executive Officer
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam

Page 4 of 4
 INVOICE

SST REG. NO. : W10-1808-31020434

INVOICE NO : EMT2300360210
CLIENT CODE :
ACCOUNT CODE : D16677-000
INVOICE DATE : 24 MAR 2023

FAIZAL BIN MOKHTAR

22-23,PLATINUM RESIDENSI TERATAI, NO.2
JALAN KURAMAN, 53000 SETAPAK,KUALA
LUMPUR
53000 KUALA LUMPUR
KUALA LUMPUR (WP) MALAYSIA

PARTICULARS

CLASS : PRIVATE CAR - Z-DRIVER

VEHICLE NO : BMC1089
VEHICLE BODY : 4D SEDAN
SEATING CAPACITY : 5
POLICY NO : 352300000788-00
PERIOD OF INSURANCE : 24 MAR 2023 TO 23 MAR 2024

No. Description Amount SST Rate SST Amount Total (RM)

1 Premium 377.22 6.00 22.63 399.85
Total Before Disbursement 377.22 22.63 399.85
Stamp Duty (Disbursement) 10.00 0.00 10.00

Total After Disbursement 387.22 22.63 409.85

PT Voucher 0.00
Total Amount Payable 409.85

A Cashier’s Receipt will be given on payment of this account

E. & O.E.
THIS IS A COMPUTER GENERATED FORM AND DOES NOT REQUIRE A SIGNATURE Page 1 of 1