PREMIUM COMPUTATION SHEET

Department : MOTOR Insured's Name : OM PRAKASH SINGH

Document No : R/212700/31/2019/1521 Document Date : 12/09/2019

Policy Start Date : 13/10/2019 Policy End Date : 12/10/2020

Product Description : PRIVATE CAR Document Type : Proposal

Policy Type : PACKAGE POLICY

SCHEDULE OF PREMIUM
Cover Description Sum Insured Premium

BASIC OD COVER 55,705.00 1,911.00

MOTOR OD BASIC - NEW 55,705.00 1,911.00
BASIC OD TOTAL 55,705.00 1,911.00
LESS :ANTI-THEFT DISCOUNT-GR-30 0.00 47.78
OD TOTAL 55,705.00 1,863.00
LESS :NO CLAIM BONUS-GR27 0.00 931.61
MOTOR TOTAL OD 55,705.00 932.00
BASIC TP COVER 0.00 3,221.00
BASIC TP TOTAL 0.00 3,221.00
ADD :PA FOR OWNER DRIVER-GR36A 15,00,000.00 320.00
ADD :LL-PAID DRIVER, CONDUCTOR,CLEANER-IMT-28 0.00 50.00
TP TOTAL 15,00,000.00 3,591.00
TOTAL PREMIUM 4,523.00
STAMP DUTY 0.50
ADD :SGST 407.00
ADD :CGST 407.00
TOTAL AMOUNT 5,337.00

RISK DETAILS

Section : PACKAGE POLICY

Vehicle Details : PD5960 / PD7050 / PB 03 P 4470
Personal Effects SI ACB No. of Days Payable Benefit

Cover Name Sum Insured Rate Premium

BASIC OD COVER 55,705.00 3.43/100 1,911.00

ANTI-THEFT DISCOUNT-GR-30 0.00 2.5/100 47.78
NO CLAIM BONUS-GR27 0.00 50/100 931.61
BASIC TP COVER 0.00 3221/1 3,221.00
PA FOR OWNER DRIVER-GR36A 15,00,000.00 320/1 320.00
LL-PAID DRIVER, CONDUCTOR,CLEANER-IMT- 0.00 50/1 50.00
28

Total 4,522.61