CERTIFICATE OF MOTOR INSURANCE

POLICY NUMBER: TBA

NAME AND ADDRESS OF INSURED:

SAMUEL SIMWIINGA
MAKE & MODEL: HONDA
C/O GALCO TRANSPORT AND LOGISTICS
COLOUR: BLUE

CHASSIS NO: GE6-1179519

Zambia ENGINE NO: L13A-4196587

TEL: 0968402171 CUBIC CAPACITY: 1330

REGISTRATION: BLB4190ZM
INSURANCE TYPE: Comprehensive
COVER FROM: 25 February 2024
SUM INSURED - OWN ZMW 80,000.00
DAMAGE: EXPIRY DATE: 28 June 2024

Premium ZMW 1,004.09

COMBINED THIRD ZMW 150,000.00
PARTY LIMIT:

INJURY & DEATH ZMW 0.00

CLAIM PER PERSON:
INJURY & DEATH ZMW 0.00
CLAIM PER EVENT:
PROPERTY DAMAGE: ZMW 0.00
The Road Transport and Safety
The Road Traffic
Special Endorsement (s)
(Traffic of Security and Insurance)
Regulations, 2015
---------------------------------- Vehicle Information
1. Driver Clause : Unless otherwise agreed, Make: HONDA Engine: L13A-4196587
driving shall be restricted to persons aged 21 years Colour: BLUE Reg. No.: BLB4190ZM
and above who have held a valid driving licence for at Year: 2009 Comprehensive
least 1 (one) year.
Chassis: GE6-1179519
Date of Issue: 21-Feb-2024 Time: 09:35
2. Claims – Third Party Recovery: In the event
of a collision, when the driver of the Third Party Expiry Date: 28-Jun-2024 Quarter: 2/24
Issued by Hollard Insurance.
vehicle is found at fault, the insured will take all
reasonable steps to bind the third Party Vehicles
driver / owner and its insurer to meet the cost of
repairs and other claims before repairs to the insureds
vehicle are authorized.

3. Excess Clause and other terms / conditions:

As per Policy Schedule / Endorsement

PREPARED BY: Debbie Phiri Miyanza

FOR THE COMPANY IN LUSAKA ON

February 21, 2024

FOR CHIEF EXECUTIVE

OFFICER HOLLARD ZAMBIA AGREEMENT NO: 2519565177