Sum An

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WHEELERCERIIFICA - P O L I C YS C H E D U L E I.]ATIONAL INSURANCECON,II'ANYLIMITED D O V I I , , 5 0 . l a n p aN r he w D c l h i I 1 0 0 0 1 35070131086200t7971 T r r : 0 1t - 4 1 5 1 4 0 9 t nrcdoTdelhi@ntc. c,,.in Business/Profession

Addressof'fhe lnsured B O R B A R I J A }T J E A E S ' | A T EP O BARBARUAH,DIRRUcARH D i b r u g a rA h SSAM 78600I

M TK A P I LS A I K I A Vehicle Regn No

A S - u 6 - F -|77 : :

05tlBAt:{)02!18

D e c l a r e dV a l u e ( | D V ) o f V e h i c l e

HLRO I{ONDA ' MO'TORSLlMITED A I . i l I E V E RD R U M KICK VISOR

Side Car IDV

HP/Lease/Ht re-Purchase ' Brzrnch Office of AgreementWlth HP/Lrase/FIi re-purchase A. Orvn Damage Premiuln

(Sectionl) in Rs.

$ a s i cP r e n r i u m0 n Vehicle

:

Accessories

: .

Flectronic& El6ctrioalAccessories

B. Liability Premium Comprt"tion

1s""tion tq intt-,

B.4sitI'remium Inctudingpremiqryrfor TpfD 5 2 E . 0 0 V'ehitle (j.00 CNCTt.PG/Bi-Fuet Kir 0.00 Add

B i - F u e lK i t 'fotal

. 300.00

a)tl:r6px;5ury PA Cover (O.rvner

Driver) '$;(:ii,tionarp_,4,;[email protected]).i -; /. ;,

Add htrlrs: CeographiL:al Extension For an! oTherextra SubTotal

AVENTUREOFHEROGROUP

LcssDiscounts

:

.:

50.00

000

; : : 1 , 1 i l 1 " : ^ ' " " " u l r l ' fi 'ltLd, ::t,dt ,f l L , ; . r o n o j,, iti;i'ir:rrj'i' l.r.r r;j e .,,,||.,1fr,1!,fJifi Ir.i;;;r l,i,i'ltt'"i il:tlu*t2,L .d,i .s,, ? kci nillj oss s6 il:,q"ij-f,ffi " |,,r"',Hiti.'iffil;;,hl';;l; rrsi,r : 0,,0 ' [ t{T' n l l . h b l i t y P r e m i u m f t 3 f \ . r , o r duni'L.,tj o l o r F ' abilp*a,,, t,], : rs'00

ior ar:rr-tirell device: 3,fi1,it:iiei disrroilri

Rfi' 7I $nff1 {/\ssam} : 746 O;agir+fU"q.U'S-tJ-G--,i 0f) ri91,,i'uti,.,6li,j3?|-l39.1". Fex: {0li7ii}ZS:elii]g ooo

NCB

1 3 2 . 0 ( l id! lhrvice Tax l . J : . 0 0 GrqssiPremiurn i96 00

T o l r l D e d r r c to n s .Net Os'n Damage premium(A)

. ,

i..oo

: S23.00

ITATIONS AS TO USE: The policy .ou".i ;;,r;l;;"

IIIIPORTANT NOTICE: The insuredis ;

*"".crion wirh Motor rrade.

jT,:fftHJ 3:f1;tt*H5Y;i*;;;;;i,,.,.0,'",. ,ess i;,;.;;;;;;i;il; ;. ins,red see,,e c,ause ,readed

i'J:iilli,i'i*':H'#KW

TRIVER:An), personincludingtn.urud, Ot

u]:?;TJ[il.T'[..,ti:fi.lj,iji:1utsonho|dinganeffectIveL"o;",';;;;"n;;'.;'ir*drivethe . I N I I T O F l - I A B I L I T ' y : L i r n i to f Companv'sliabilityunderSeci

Company'sliability under,l,. S"oi* ffiO orujLjIEj,BIn ,lj:!!lji.toi,rrlaiisir4, o.urnion.

e certil!'thatthe

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th"."njfi".

",,.,r,

,ijo,o n, t00r)00i-

;.m

X & XI ofM V. Act I988 policy is subjectto a compulsoryexcessof Rs. i a t i o n i s a p p l i c a b l ea s p e r p o l i c l t e r r n s& ronsx (Pleaseturn overleaffor details)

\t*:l-a

J

G 0 N C Y C O D E : 9 l ? 9 0i 0 | r-q-N4ay'2009 )ate& Srgnature of T

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FOR RENIWALS CONTACT: PASHUPATITRADT]RS N R i ) A D .C I I I R I N GC ' H A p O R t ,

behalo f f N A ' r I O N A LT N S U R A N C E COMptNy

d{,:u' ConstitutedAttorney

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