Book traversal links for Schedule No. (5)
Schedule No. (5)
Effective from 22/9/2016"Schedule of Details of the Insured Motor Vehicle in the Insurance Policy against Third Party Liability"
Details of Motor Vehicle | ||||||||
Country of Manufacture | Plate Number | Make, Model and Color | Motor Vehicle Classification | Registration Type | Purpose of use | Manufacturing Year | Tonnage | Number of Passengers with Driver |
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Engine Number: | Chassis Number: |
……………………….. Company declares that the Motor Vehicle detailed above inthis Schedule is insured with it according to the provisions of this Policy.
Issued By: Issuance Date:
Policy Number:
The term of insurance begins at …………. on …/…/….., and expires at …………. on …/…/….. Total premium: Issuance date: …/…/….. | |||||
Insured's Details | Company's Details | ||||
Insured's Name | : |
| Company's Name | : |
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Address | : |
| Address | : |
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: |
| : |
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Postal Address | : |
| Postal Address | : |
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Phone | : |
| Phone | : |
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Identification Number | : |
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Name and signature of the Insured or their representative: | Signature and stamp of the Company: |