Proposal Page Page 1 of 1

Request Details
Request ID R86734322 Package Policy ( Private Vehicle )
Name: MRS RUCHITA R TAPKIRE Date of Birth :
Address: AT NAVENAGAR, SUTARALI, MAHAD , RAIGAD - 402301, 28-Mar-1967
Proposal Date:
Period Of Insurance From 21-Apr-2019 to midnight on 20-Apr-2020
12-Apr-2019
The Vehicle NEW ALTO K10 VXI AGS (O)
Registration Mark & Place Of
Geographical Area Engine-Chassis No. CC Mfg.Year Seating Capacity
Registration
INDIA 2120356 - 421644 998 2018 5 MH06BU2753 / PEN
INSURED'S DECLARED VALUE
Vehicle & Non Elec accessories Elec accessories CNG/LPG kit Total Value (IDV)
344462 0 0 344462

Schedule Of Premium
A. OWN DAMAGE B. LIABILITY
Vehicle & Accessories : 4712 Vehicle 1850
Total 4712 Total 1850
Add 4712 Add 1850

b) Geographical Area Extn. NA a) Compulsory PA Cover Premium [1 Year] 325

Additional PA Cover Premium (100000 per person)For 5 Person(IMT-

Sub-Total Additions 0 b) 250
16)
5% Extra premium towards inbuilt
c) NA
CNG/LPG

Less d) Legal Liability (WC) to Driver (IMT-28) 50

g) For Anti-theft Devices (IMT-10) 118 e) Legal Liability to Employees (IMT-29) NA

h) Auto Association membership NA f) Legal Liability to unnamed Passanger (IMT-37A) NA

h) Driving Tuition Loading On TP Premium (60%) 0

Sub-Total (deductions) 118
Zero Depreciation Premium 2067
Engine and Gear box protection 620
Return To Invoice 689
Total (A) 7970 Total (B) 2475
Grand Total 10445
CGST 9% 940
SGST 9% 940
Total Premium 12325
Compulsary Deductables 1000
Lease/HP/Hypothecation: / MAHAD
Nominee Details For Compulsary PA RAJKIRAN
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