Documente Academic
Documente Profesional
Documente Cultură
R.S.D. :- 01/04/2015
1. Client Name :2. Client DOB :-
4. Intermediatry Code :5. Intermediatry Name :6. Vehicle Make & Model :-
3. Client Address :-
Rs.
No
Trailer
4 Wheeler/ 3 Wheeler
No
Cubic Capacity
Calculation
method
Previous Policy
Expiry date
13-Sep-12
2014
A
1248
Type of Cover
Pro-rate
Comprehensive
Policy Period
Inception date Expiry date
365.00
10-Mar-15
09-Mar-16
Premium Calculation
Basic OD
Special Discount
Special Loading
Net Basic OD
Non-Elec Accessories
Elec Accessories
Bi-fuel Kit
Basic OD1
Trailer
Geographical Area
Embassy Loading
Fibre Glass Tank
Driving Tuitions
Rallies (no of days)
Basic OD2
Discounts
Anti Theft
Handicap
AAI
No
No
No
Rs.
Rs.
Rs.
Vintage Car
No
Own Premises
No
Voluntary deductible
0
Basic OD3
NCB
20%
Total Anuual OD Premium
Total OD Premium for the policy period
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
10,472.77
2,094.55
8,378.22
8,378.22
Premium Posting
Total Premium
Add Service tax
Total payable
Basic TP
Restricted TPPD
Trailer
Bi-fuel kit
Basic TP1
Compulsory PA own/driver
Geographical Area
Unnamed PA Pax
No
Yes
No
5
Yes
1
No
1
LL Drv/Emp
No of Drv/Emp
LL to defence
No of persons
Basic TP2
Total Annual TP Premium
Total TP Premium for the policy period
ADD ON COVERS PREMIUM
Add On Covers
Rate
Plan:
Plan 1
0.45
Other covers: Consumables
Tyre Cover
NCB Protection
Engine Protector
Return to Invoice
Inconvenience Allowance
No
Total Annual Add On Cover Premium
Total Add On Cover Premium for the policy period
Rs.
Rs.
Rs.
12,736
1,576
14,312
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
1,598.00
1,598.00
100.00
100,000
50.00
Rs.
Rs.
Rs.
Rs.
1,748.00
1,748.00
1,748.00
Rs.
Not Opted
Not Opted
Not Opted
Not Opted
Not Opted
Not Opted
Rs.
Rs.
2,610.00
2,610.00
2,610.00
Pvt Car
Basic OD
OD
A
0
6
11
upto 150
B
A
1.708
1.676
1.793
1.760
1.836
1.802
151to 350
150
0
6
11
B
1468
1468
1468
1.793
1.883
1.928
A
1.760
1.848
1.892
1000
A
1468
1468
1468
B
1468
1468
1468
A
1468
1468
1468
Theft only
Fire only
0.50%
0.50%
Fire&Theft only
0.75%
2500
750
25.00%
5000
1,500
30.00%
7500
2,000
15000
2,500
Comprehensive
voluntary excess
Slabs
Discount
0
1.879
1.973
2.020
TP
350
Basic TP
A
over 350 cc
B
1468
1468
1468
100%
Liability only
Calculation of Basic OD
4W / 3W
Zone
CC
Age
Col Offset
Basic OD
Comprehensive
Col Offset
A
1248
1
10
3.283
3.283
Calculation Of Basic TP
Basic TP
1598
1
151
351
751
1001
1501
B
8
8
8
8
10
12
9
5
7
9
11
13
over 350 cc
1000
B
A
B
1.844
3.127
1.936
3.283
1.982
3.362
1000
B
3.039
3.191
3.267
1000
B
A
1468
1468
1468
1500
A
B
3.283
3.447
3.529
A
3.191
3.351
3.430
1500
9999
1468
1468
1468
1468
1468
1468
9999
B
3.440
3.343
3.612
3.510
3.698
3.594
1598
1598
1598
A
1598
1598
1598
B
4931
4931
4931
4931
4931
4931
20%
30%
40%
50%
60%
70%
80%
90%
100%
100%
0
32
63
93
124
154
185
216
246
367
A
0
6
11
upto 150
151to 350
over 350 cc
B
A
B
A
1.708
1.676
1.793
1.760
1.879
1.793
1.760
1.883
1.848
1.973
1.836
1.802
1.928
1.892
2.020
1.564
1.642
1.681
1000
1.52
1.596
1.634
1.642
1.724
1.765
1.596
1.676
1.715
1.72
1.806
1.849
1500
9999
B
A
B
A
3.127
3.039
3.283
3.191
3.440
3.283
3.191
3.447
3.351
3.612
3.362
3.267
3.529
3.430
3.698
over 350 cc
B
1.844
1.936
1.982
1.672
1.755
1.797
9999
B
3.343
3.510
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3.594
Insured Name
Vehicle Registration
Previous Policy
Policy
No. Inception
Expiry Date
Date