PREMIUM COMPUTATION SHEET

Department : MOTOR Insured's Name : MRS.PRATIBHA

Document No : R/272102/31/2019/1415 Document Date : 03/04/2019

Policy Start Date : 06/04/2019 Policy End Date : 05/04/2020

Product Description : PRIVATE CAR Document Type : Proposal

Policy Type : PACKAGE POLICY

SCHEDULE OF PREMIUM
Cover Description Sum Insured Premium

BASIC OD COVER 63,000.00 2,118.00

MOTOR OD BASIC - NEW 63,000.00 1,363.00
ADD :CNG-KIT-COVER-GR42 10,000.00 400.00
LESS :Underwriter's Discount 0.00 755.00
BASIC OD TOTAL 73,000.00 1,763.00
OD TOTAL 73,000.00 1,763.00
MOTOR TOTAL OD 73,000.00 1,763.00
BASIC TP COVER 0.00 1,850.00
ADD :CNG KIT - TP COVER-GR-42 0.00 60.00
BASIC TP TOTAL 0.00 1,910.00
ADD :PA FOR OWNER DRIVER-GR36A 15,00,000.00 320.00
TP TOTAL 15,00,000.00 2,230.00
TOTAL PREMIUM 3,993.00
STAMP DUTY 0.50
ADD :CGST 359.00
ADD :SGST 359.00
TOTAL AMOUNT 4,711.00

RISK DETAILS

Section : PACKAGE POLICY

Vehicle Details : 1290920 / 350779 / DL 09C W 1534
Personal Effects SI ACB No. of Days Payable Benefit
Rs.400/- Per Day

Cover Name Sum Insured Rate Premium

BASIC OD COVER 63,000.00 3.362/100 2,118.00

CNG-KIT-COVER-GR42 10,000.00 4/100 400.00
Underwriter's Discount 0.00 30/100 755.00
BASIC TP COVER 0.00 1850/1 1,850.00
CNG KIT - TP COVER-GR-42 0.00 60/1 60.00
PA FOR OWNER DRIVER-GR36A 15,00,000.00 320/1 320.00

Total 3,993.00