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customersupport@icicilombard.com
Insured
Business/Profession
Valid From
To
Mr RAJESWARA RAO
borra
Employed
D NO 5-142 ARTHAMURU
BANTUMILLI MND Machilipatnam
ANDHRA PRADESH 521369
08-01-2015 0:00:00
Midnight of 07-012016
Engine No.
Year of Mfg
Cubic Capacity
2012
150
Frame No.
Hero
MotoCorp
MBLKC12EHCGL05328 (formerly Hero
Honda)
XTREME DSS
AP-16-AY-1574
KC12EECGL07533
Non-Electrical
Accessories IDV
Electrical
Accessories
IDV
CNG/LPG/Bi-Fuel IDV
Total IDV
46200.00
NA
0.00
0.00
NA
46200.00
Place of Regn.
Body Type
HP/Lease/Hire-Purchase
Agreement With
Branch Office
of
HP/Lease/HirePurchase
Seating Capacity
Premium
Machilipatnam
Solo
---
---
1347.00
Basic Premium On
Vehicle
697.00
Accessories
0.00
CNG/LPG/Bi-Fuel Kit
0.00
Add
Bi-Fuel Kit
Total
:
:
464.00
:
:
:
50.00
:
:
0.00
Less Discounts
514.00
Total Premium (A + B)
: 1198.00
: 0.00
: 149.00
: 1347.00
Vehicle
Add Extras:
Geographical Extension
0.00
231.00
ND Cover
Sub Total
928.00
0.00
244.00
Total Deductions
244.00
Gross Premium
684.00
(35 %)
0.00
0.00
Legal Liability
NCB
0.00
0.00
DRIVER: Any person including insured: Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified
from Holding or obtaining such a licence.Provided also that the person holding an effective Learner's Licence may also drive the vehicle and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act 1988.
Limit of the amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event : Upto Rs
100000/I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with the provisions of Chapter X &
XI of M.V. Act 1988
Dated
Nominee Name
Drawn on
Nominee Age
Acknowledgement Dt
08-Jan-2015
Date & Signature of
proposer
Received Vide
1347.00
CASH
Cash/Cheque No.
07-012015
Nominee
Relation
Father
http://www.nsureplus.com/Nsureplus/Policy/PolicySchedule.aspx
07-01-2015