Motor Two Wheeler 1602272312012789: Product Name

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Product Name -- Motor Two Wheeler Policy Number 1602272312012789 Date: 01/12/2017

Insured Name: Mr. PUNIL H JOSHI Branch Code /Name 1602 - Ahmedabad I

Insured B 2 200 MADHUVRUND SOC RANNA PARK,GHATLODIA Service Branch Address 3rd Floor, Zodiac Avenue,Opp Mayor's Bunglow, Nr Law Garden,Ellisbridge, Ahmedabad
,AHMADABAD CITY,AHMEDABAD,GUJARAT-380061 AHMEDABAD AHMEDABAD GUJARAT-380006
Address:
Contact Nos.: Region Code/ Name Gujarat

E-mail address: Agent Code / Name 16A31957 - BHAVIN SHAH

Ref : Renewal of BAJAJ PLATINA Policy Number 1602272312012789 valid upto 10/01/2018
Dear Sir/Madam,
It has been a privilege servicing your insurance needs during this year.
We would like to extend this valuable relationship to the next year by inviting renewal of the policy against the premium shown in this Renewal Invitation so as to enjoy continuity in coverage.
Please note that Renewal Invitation has been generated as per expiring terms, considering your No Claim Bonus entitlement as on 29/10/2017
In case of any change in the actual claim status subsequent to the date of this communication NCB discount would be withdrawn and premium would get modified.
We strongly recommend that the policy be renewed well in advance,i.e. on or before 10/01/2018 to avoid the risk of your vehicle remaining
uninsured during the gap and also having to undergo the process of Inspection of the vehicle before acceptance.

Yours truly,

Authorised Signatory
VEHICLE DETAILS
MFG Year Registration Number Engine No Chassis No Claim Status Existing IDV Registration Vehicle Eligible NCB Hypothecated To
Date CC/GVW (Kgs)
2015 GJ01EX4107 PFZRFE83049 MD2A76AZ3FRE55572 No 41280 18-09-2015 100 20%
00:00:00

* Premium Calculation Schedule for Package Policy *


Existing Renewal Details Amt in Rs Changes, if any Existing Renewal Details Amt in Rs Changes, if any
Total Liability Premium: - (B) 770
Vehicle Renewal IDV 30100 Package Premium: (A + B) 1181
IGST / CGST + SGST Or UTGST: 213
Total Own Damage Premium:- (A) 411
Final Premium (C): 1394

Please attach Self attested copy of RC for Changes/Correction to be made in Vehicle Details and Letter from Financier in case of Change/Correction in HYP/HPA.
Please let us have your Latest/Correct contact details and help us to serve you better.
Address :______________________________________ Res. Phone / Off. Phone
______________________________________ Mobile No.
_________________________________ Email ID
Please write your Cheque or Demand Draft in favour of Reliance General Insurance Company Ltd. (As per the RBI Circular No. 955 dated 14.12.2012, You are requested to issue CTS-
2010 Standard cheques only.)
Chq/DD Number:__________________ Date:______________ Amount Rs:____________ Bank Name:__________________________ Branch:_________
Signature of the Insured Dated:
01-Dec-2017 - 16A31957 Branch - Ahmedabad I
16A31957 365128
Prohibition of Rebates - Section 41 of the Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015.
1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the
commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or
tables of the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

IRDAI of India Registration No. 103 An ISO 9001:2008 Certified Company


Insurance is a subject matter of solicitation. Reliance General Insurance Company Limited.
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.
Registered Office: 19, Reliance Centre, Walchand Hirachand Marg, Ballard Estate, Mumbai 400001.
Corporate Office: Reliance centre,4th floor,South Wing,Near Prabhat Colony,Santacruz(East), Mumbai-400 055.
Corporate Identity No. U66603MH2000PLC128300.
RGI/MCOM/MOT-20/RN/Ver. 1.0/161014

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