GATE WAY

GATE WAY
PREMIUM AUTO CALUCULATION
PREMIUM AUTO CALCULATION (New S.T & Fire Special)

PRODUCT NAME
VERSION 5.7 (New S.T & Fire Special) TWO WHEELERS
Developed By :
PRIVATE CARS
N. SATEESH KUMAR
Executive Operations, Vizag

FOUR WHEELER TAXIS

COMMERCIAL VEHICLES
(Passenger & Good Carrier)

COMMERCIAL VEHICLES
(Buses etc.,)

TRACTORS

CONSTRUCTION EQUIPMENTS

MOTOR TRADE ROAD RISK

MOTOR TRADE ROAD TRANSIT

OWNERSHIP TRANSFER

STAND ALONE TP PREMIUMS

FIRE SIMPLE RISK

FIRE STORAGE RISK

FIRE LONG TERM DWELLING

SHOP KEEPERS

HOUSE KEEPERS

OFFICE PACKAGE

PERSONAL GUARD

HEALTH GUARD

HOSPITAL CASH

TRAVEL COMPANION

MOTOR DEALERS

WORKMEN COMPENSATION
TO
Date : 11/04/2021
Mr. N. Satish,
Visakhapatnam
QUOTATION FOR TWO WHEELERS
TWO WHEELERS :
1.793 1.793 1.883 1.973
NCB VEHICLE IDV
SUM INSURED Upto 75 cc
Upto 75CC 7675CC
cc to 150CCcc
to 150 151
150cc
CCto 350CCcc
to 350 Above 350CCcc
Above 350
RATE RATE RATE RATE
Select NCB :- 500000 (%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION

Select Zone :- A Own Damage :- Basic OD : 1.793 8965 1.793 8965 1.883 9415 1.973 9865
Select Age :- 5 to 10 Yrs (-) Voluntary Deductibles :- 0 0 0 0 0 0 0 0 0
(-) De-Tariff Discount :- 0 0 0 0 0 0 0 0 1
Total OD (After De-Tariff Disc):- 8965 8965 9415 9865 2
Additional Opitions :-
(-) No Claim Bonus : 0 0 0 0 0 0 0 0 3
P.A Cover : Total Own Damage : 8965 8965 9415 9865 4

Loading : Public Liability :- Basic T.P : 300 300 300 620 5

Voluntary Dec : 0 (+) Compulsory PA : 50 50 50 50
Total Premium :- 9315 9315 9765 10535 6
De-Tariff Ratings :-
(+) Additional Loading :- 0 0 0 0 0 0 0 0 7
Discount allowed : No Net Premium :- 9315 9315 9765 10535 8
Enter Discount % : 20 Service Tax :- 12.36 1152 12.36 1152 12.36 1207 12.36 1303 9
FINAL PREMIUM :- 10467 10467 10972 11838 10
TPPD Restd Premium (N.ST) :- 10412 10412 10917 11783

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Mr.Sateesh Garu Date : 11/04/2021
Visakhapatnam
QUOTATION OF FOUR WHEELER
GATE WAY P R I V A T E C A R ( F/W ) TARIFF
Sateesh, Vsp

PRIVATE CAR :- Ex-Showroom : 463235 5%idv: 440073

3.127 3.283 3.44
NCB
NCB VEHICLE IDV
SUM INSURED Upto 1000 cc
< 1000CC 1001
> 1000cc
CC to
to <1500 cc
1500 CC Above 1500
> 1500 CC cc
RATE RATE RATE
Enter here :- 0 400000 (%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION

Zone :- A Own Damage :- Basic OD : 3.127 12508 3.283 13132 3.44 13760
Age of Vehicle :- < 5 Yrs (+) Electronic Accessories : 4 0 4 0 4 0
(+) Own Damaga CNG KIT : 4 0 4 0 4 0
(-) Voluntary Deductible : 0 0 0 0 0 0
Additional Coverages :-
(-) De-Tariff Discount :- 30 3752 30 3940 30 4128
P.A Cover : Total OD (After De-Tariff Disc):- 8756 9192 9632
Elec Accessories : (-) No Claim Bonus : 0 0 0 0 0 0
CNG KIT : (+) Total Own Damage : 8756 9192 9632
Voluntary Decd : Public Liability :- Basic T.P : 670 800 2500
Additional Loading : (+) Compulsory PA : 1 100 1 100 1 100
(+) LL to Employee : 1 25 1 25 1 25
De-Tariff Ratings :- (+) Public Liability of CNG/LPG Kit : 0 0 0 0 0 0
Discount allowed : Yes (+) Additional P.A : 0 0 0 0 0 0
Enter Discount % : 30 (+) Additional Loading : 0 0 0 0 0 0
Net Premium : 9551 10117 12257
Service Tax : 12.36 1181 12.36 1251 12.36 1515
FINAL PREMIUM :- 10732 11368 13772

Thank You,

For Bajaj Allianz General Insurance Ltd.,

(Authorised Signatory)
To
Mr.Sateesh Garu Date : 11/04/2021
Visakhapatnam
QUOTATION OF FOUR WHEELER
GATE WAY FOUR WHEELERS TAXIS TARIFF
Sateesh, Vsp

TAXIS (F/W) :- Ex-Showroom : 761000 5%idv: 722950

3.284 3.448 3.612 0 985200 #REF! 1034400 #REF! 1083600 #REF!
NCB
NCB VEHICLE IDV
SUM INSURED Upto 1000 cc
< 1000CC 1001
> 1000cc
CC to
to <1500 cc
1500 CC Above 1500
> 1500 CC cc 0 2500 197040 750 #REF! 206880 750 #REF! 216720 750 #REF!
RATE RATE RATE
Enter here :- 0 30000000 (%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION Yes
0
5000 246300
1500
258600
1500
270900
1500
Zone :- A Own Damage :- Basic OD : 3.284 985200 3.448 1034400 3.612 1083600 No 7500 295560 2000 310320 2000 325080 2000
Age of Vehicle :- < 5 Yrs (+) Electronic Accessories : 4 0 4 0 4 0 0 A 15000 344820 2500 362040 2500 379260 2500
(+) Own Damaga CNG KIT : 4 0 4 0 4 0 1 0 < 5 Yrs 3.284 3.448 3.612 0 0 0
(-) De-Tariff Discount :- 15 147780 15 155160 15 162540 2 20 5 to 10 Yrs 3.366 3.534 3.703
Additional Info :-
Total OD (After De-Tariff Disc):- 837420 879240 921060 3 25 > 10 Yrs 3.448 3.62 3.793
No.of Passengers : 5 (-) No Claim Bonus : 0 0 0 0 0 0 4 35 B
Elec Accessories : (+) Total Own Damage : 837420 879240 921060 5 45 3.191 3.351 3.51
CNG KIT : Public Liability :- Basic T.P : 1650 2330 2840 6 50 3.271 3.435 3.598
Additional Loading : (+) Compulsory PA : 1 100 1 100 1 100 7 A B 3.351 3.519 3.686
(+) LL to Employee : 1 25 1 25 1 25 8
De-Tariff Ratings :- (+) Public Liability of CNG/LPG Kit : 0 0 0 0 0 0 9 1 1 1
Discount allowed : Yes (+) Passengers (Licd Carr.,) : 5 1750 5 1750 5 1750 10 1 3.284 1 3.448 1 3.612
Enter Discount % : 15 (+) Additional Loading : 0 0 0 0 0 0 0 3.271 0 3.435 0 3.598
Net Premium : 840945 883445 925775 0 3.351 0 3.519 0 3.686
(+) Service Tax : 12.36 103941 12.36 109194 12.36 114426
FINAL PREMIUM :- 944886 992639 1040201

Yes
No

Yes A 15000
No < 5 Yrs 3.284 3.448 3.612
0 5 to 10 Yrs 3.366 3.534 3.703
20 > 10 Yrs 3.448 3.62 3.793
25 B
35 3.191 3.351 3.51
45 3.271 3.435 3.598
50 A B 3.351 3.519 3.686

#REF! #REF! #REF!

#REF! #REF! #REF! #REF! #REF! #REF!

#REF! #REF! #REF! #REF! #REF! #REF! FOUR WHEELER TAXIS

Four Wheeler Vehicles and Three wheeled Vehicles used for carrying Passengers for Hire or Reward
#REF! #REF! #REF! #REF! #REF! #REF! with carrying capacity not exceeding 6 (Six) Passengers - CLASS C1

BACK
RATES OF PREMIUM FOR OWN DAMAGE RISKS

ZONE B ZONE A
CUBIC CAPACITY CUBIC CAPACITY
Not exceed -ing Exceed -ing Exceeed-ing Not exceed -ing Exceed -ing Exceed -ing
1000cc 1000cc but not 1500 cc 1000 cc 1000cc but not 1500 cc
Age of Vehicles exceed -ing 1500 exceed -ing
cc 1500 cc

3.510 % on
Not Exceeding 5 years 3.191 % on IDV 3.351 % on IDV 3.284 % on IDV 3.448 % on IDV 3.612 % on IDV
IDV

Exceeding 5 years but 3.598 % on

3.271 % on IDV 3.435 % on IDV 3.366 % on IDV 3.534 % on IDV 3.703 % on IDV
not exceeding 7 years IDV

3.686 % on
Exceeding 7 years 3.351 % on IDV 3.519 % on IDV 3.448 % on IDV 3.620 % on IDV 3.793 % on IDV
IDV

PREMIUM FOR LIABILITY ONLY COVER :-

Cubic Capacity of the Vehicle Premium

Rs. 1,650/- + Rs. 350/- x
Total no. of passengers
Not exceeding 1000 cc
the vehicle is licensed to
carry.

Rs.2,330/- + Rs. 350/- x

Total no. of passengers
Exceeding 1000 cc but not exceeding 1500 cc
the vehicle is licensed to
carry.

Rs.2,840/- +Rs. 350/- x

Total no. of passengers
Exceeding 1500 cc
the vehicle is licensed to
carry.

Thank You,

For Bajaj Allianz General Insurance Ltd.,

(Authorised Signatory)
To

Mr. Amit Mohanty Date : 11/04/2021

Visakhapatnam. QUOTATION FOR COMMERCIAL VEHICLE

HEAVY GOODS VEHICLES (LORRIES / MAX /ACE / JEEP etc) :-

1.726

NCB SUM INSURED AMOUNT

PASSENGER CARRIER

NCB :- 100000 RATE CALCULATION

Actual Weight :- 16200 Own Damage :- Basic OD : 1.726 1726

Add Passenger :- (+) Surcharge for G.V.W : 4200 1134
Age of Vehicle :- < 5 Years (-) De-Tariff Discount :- 10 286
Zone :- C Total OD (After De-Tariff Disc):- 2574
De-Tariff Ratings :- (-) No Claim Bonus : 0
0 0
Discount allowed : Yes TOTAL OD DAMAGE : 2574 20
Enter Discount % : 10 Liability :- Basic T.P : 6090 25
Yes (+) No. of Passengers : 0 0 35
No (+) Comp P.A. Cover : 1 100 45
(+) LL to Employee : 1 25 50
Net Premium : 8789
Service Tax : 12.36 1087
FINAL PREMIUM :- 9876

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
TO
Date : 11/04/2021
Mr. N. Satish, QUOTATION OF MISC AND SPECIAL TYPE OF VEHICLE
Visakhapatnam.

NCB SUM INSURED

RATE AMOUNT AMOUNT
Select NCB Here :- 4037500 % Rs. Rs.

Select Overturning here :- NO Own Damage :- Basic OD : 1.19 48046

Age of Vehicle :- < 5 Years (+) Overturning : 0 0
Zone :- C (-) De-Tariff Discount :- 0 0
De-Tariff Ratings :- Total OD (After De-Tariff Disc):- 48046
Discount allowed : NO (-) No Claim Bonus : 0 0
Enter Discount % : 10 TOTAL OD DAMAGE : 48046
Public Liability :- Basic T.P : 800
(+) LL to Employee : 1 25
(+) Comp P.A. Cover : 1 100
YES Net Premium : 48971
NO Service Tax : 12.36 6053
FINAL PREMIUM :- 55024
INCLUDING EXTENDED WARRANT PREMIUM :-

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Date : 11/04/2021

QUOTATION FOR COMMERCIAL VEHICLES

(PASSENGER CARRIER MORE THAN 6 NOS. BUSES, ETC.,)

COMMERCIAL VEHICLES (BUSES, TOURIST VEHICLES etc.,) :-

1.68 1.68 1.68 1.68
NCB SUM INSURED < 18 Passengers 19 to 36 Passengers 37 to 60 Passengers > 60 Passengers
RATE RATE RATE RATE
NCB Percentage :- 65000 (%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION
(%)
CALCULATION

Zone :- A Own Damage :- Basic OD : 1.68 1092 1.68 1092 1.68 1092 1.68 1092
Age of vehicle :- > 5 Years (+) Basic OD amount : 350 350 450 450 550 550 680 680
(-) De-Tariff Discount :- 0 0 0 0 0 0 0 0
Total OD (After De-Tariff Disc):- 1442 1542 1642 1772
Additional Coverages :-
(-) No Claim Bonus : 0 0 0 0 0 0 0 0
No. of Passengers:- 3 (+) Total Own Damage : 1442 1542 1642 1772
LL TO EMP :- 2 Liability :- Basic T.P : 3160 3160 3160 3160
PA COVER :- (+) Comp P.A. Cover : 0 0 0 0
De-Tariff Ratings :- (+) LL to Employee : 50 50 50 50
Discount allowed : No (+) LL to passengers : 3 705 3 705 3 705 3 705
Enter Discount % : 20 Net Premium : 5357 5457 5557 5687
Service Tax : 12.36 663 12.36 675 12.36 687 12.36 703
Yes FINAL Premium :- 6020 6132 6244 6390
No

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
 C
O
To M
M Date : 11/04/2021
Mr. N.Sateesh, E
Visakhapatnam
R
QUOTATION FOR TRACTOR
C
I
A
TRACTOR TRAILOR SUM COMMERCIAL TRACTOR
AGRICULTURAL TRACTOR L
SUM INSURED INSURED (With 25% Loading)

384750 RATE
TRACTOR CUM
TRACTOR TRAILOR
T DESCRIPTION
RATE
TRACTOR
CUM
ONLY
TRAILOR % TRACTOR
R TRAILOR

Tractor OD : A Tractor OD :
1.19 4579 4579 0 1.19 4579 4579
C
0 Trailor OD : 1.05 0 0 0 T Trailor OD : 1.05 0 0
> 5 Year (-) No Claim Bonus : 0 0 0 0 O TOTAL : 4579 4579
C TOTAL OWN DAMAGE : 4579 4579 0 R (-) No Claim Bonus: 0 0 0
Tractor Public Liability :- Basic T.P : 800 800 0 TOTAL : 4579 4579
(+) Comp P.A : 100 100 0 (+) Loading : 25 1145 1145
(+) LL to Employee : 25 25 0 TOTAL OD PREMIUM : 5723 5723
(+) Fire Contents at Farmers House : 40 40 0 LIABILITY:- Basic T.P : 800 800
Trailor Public Liability :- Basic T.P : 550 0 550 (+) Comp P.A : 100 100
No. of Coolies : 0 0 0 0 (+) L.L.to Emp : 25 25
Net PREMIUM : 6094 5544 550 (+) Fire Content : 40 40
Service Tax : 12.36 754 686 68 (+) Basic Trailor T.P 550 0
FINAL PREMIUM :- 6848 6230 618 (+) No of Coolies : 0 0 0
NET PREMIUM : 7238 6688
405000 :- EX-Show room Price Service Tax 12.36 895 827
384750 :- 5% Dep IDV FINAL PREMIUM :- 8133 7515

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Date : 11/04/2021
Mr. N. Satish,
Visakhapatnam
QUOTATION FOR MOTOR TRADE ROAD TRANSIT

MOTOR TRADE ROAD TRANSIT (CLASS E) :-

0.40
PASSE
NGER
DISTANCE SUM INSURED PREMIUM COMPUTATION
CARRIE
R
RATE
Enter Kms here :- 900 627536 %
CALCULATION

De-Tariff Ratings :- Own Damage :- Basic OD : 0.40 2510

Manual Rating : No (-) De-Tariff Discount :- 0 0
Enter Rate : 10 Total OD (After De-Tariff Disc):- 2510
Yes Liability :- Basic T.P : 500
No NET PREMIUM :- 3010
(+) Addl Loading :- 0
Service Tax : 12.36 373
FINAL PREMIUM :- 3383

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Date : 11/04/2021
M/s T.R.Pioneer Agro Equip Motors (p) Ltd.,
Guntur.
QUOTATION FOR MOTOR TRADE ROAD RISK

MOTOR TRADE (OTHERTHAN TWO WHEELERS) :-

PASSE
Add NGER
Details SUM INSURED PREMIUM COMPUTATION
CARRIE
R
RATE
No. of Add Certificates :- 3500000 %
CALCULATION
Demonistration Usage :- NO Own Damage :- Basic OD : 0.45 15750
(+) Additional Loss of Damage : 1 34750
YES (+) OD of Additional Certificates : 0 0
NO TOTAL OD DAMAGE : 50500
Liability :- Basic T.P : 550
0 (+) TP of Additional Certificates : 0 0
(+) L.L. to Employee : 0 0
TOTAL (OD + LIB) : 51050
(+) Demonistration : 0 0
Net Premium : 51050
Service Tax : 12.36 6310
FINAL PREMIUM :- 57360

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
 To
Date : 11/04/2021
M/s T.R.Pioneer Agro Equip Motors (p) Ltd.,
Guntur.
QUOTATION FOR MOTOR TRADE ROAD RISK

UTATION

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
 CALCULATION OF OWNERSHIP TRANSFER FEE

DESCRIPTION
DESCRIPTION FROM
FROM TO
TO DAYS

Enter Policy Effecting 9/30/2006 9/29/2007 Total days 364

Transfer Effecting 2/2/2007 9/29/2007 Remaing days 239
Enter Actual NCB Given in Policy :- 2507 Gross Amount 1646
S.T 12.36% 203

NCB Recovery Amount :-

1851 Net Amount
1850
Transfer Fee :- 50
Total Premium for Tranfer :- 1901
 BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.,
AREA OFFICE, VISAKHAPATNAM
STANDALONE TP PREMIUMS
Motor Cycles/Scooters

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for
Two Wheelers for Owner
Premium Owner -Cum-
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Upto 350 cc 300 393 337

Above 350 cc 620 752 696

Private Cars
TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Private Cars for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Upto 1000 cc 670 864 752 892

Between 1000cc & 1500 cc 800 1010 898 1038
Above 1500 cc 2500 2918 2806 2946

Goods Carrying 3 Wheelers - Public Carriers

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Goods Carrying Vehicles Public Carriers for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Goods carrying Commercial ( 3 Wheelers) 1530 1830 1717 1858

Goods Carrying 3 Wheelers - Private Carriers

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Goods Carrying Vehicles Public Carriers for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Goods carrying Commercial ( 3 Wheelers) 1450 1740 1627 1768

Goods Carrying Otherthan 3 Wheelers - Public Carriers

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Goods Carrying Vehicles Public Carriers for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Not Exceeding 7500 Kgs 5580 6375 6263 6403

Exceeding 7500 Kgs but not exceeding 12000 Kgs 5920 6757 6645 6785
Exceeding 12000 Kgs but not exceeding 20000 Kgs 6090 6948 6835 6976
Exceeding 20000 Kgs but not exceeding 40000 Kgs 6260 7138 7026 7167
Exceeding 40000 Kgs 6770 7711 7599 7739

Goods Carrying Otherthan 3 Wheelers - Private Carriers

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Goods Carrying Vehicles Private Carriers for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Not Exceeding 7500 Kgs 5000 5724 5612 5752

Exceeding 7500 Kgs but not exceeding 12000 Kgs 5300 6061 5949 6089
Exceeding 12000 Kgs but not exceeding 20000 Kgs 5440 6218 6106 6246
Exceeding 20000 Kgs but not exceeding 40000 Kgs 5610 6409 6297 6437
Exceeding 40000 Kgs 6050 6903 6791 6931

Page 14 of 32
 BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.,
AREA OFFICE, VISAKHAPATNAM
STANDALONE TP PREMIUMS

Passenger Carrying Autos

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
3 wh Passenger Carrying Vehicles for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA incl. S.Tax
incl. S.Tax

Upto 6 Passengers 510 685 572 713

Between 7 and 17 Passengers 1560 1863 1751 1891
Exceeding 17 Passengers 3160 3659 3547 3687
Add: Premium for LL to passengers @ 315 X
For Eg. If licenced carrying capacity is 3 then 315 x 3= Rs.945
Carrying Capacity (Upto below 17 Pass)
Add: Premium for LL to passengers @ 235 X
For Eg. If licenced carrying capacity is 10 then 235 x 10= Rs.2350
Carrying Capacity (Above 17 Pass)

Passenger Carrying -Taxis - Upto 6 Seaters

TP Premium
TP Premium
Excl.
incl. Coverage
4 wh Passenger Carrying Vehicles upto 6 Base TP Coverage for Incl. Paid Driver
for Owner
passengers Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA Incl.S.Tax
Incl.S.Tax

4 wh Upto 1000 cc 1650 1964 1852 1992

4 wh Between 1000cc & 1500 cc 2330 2727 2615 2755
4 wh Above 1500 cc 2840 3300 3188 3328

Add: Premium for LL to passengers @ 350 X

For Eg. If licenced carrying capacity is 5 then 350 x 5= Rs.1750
Carrying Capacity

Passenger/Employee Carrying Buses / School Buses

TP Premium
TP Premium
Excl.
4 or more Weheelers Passenger Carrying incl. Coverage
Base TP Coverage for Incl. Paid Driver
Vehicles Exceeding 6 passengers incl. School for Owner
Premium Owner -Cum- incl. S.Tax
Buses -Cum-Driver
Driver PA
PA Incl.S.Tax
Incl.S.Tax

Exceeding 6 passengers 3160 3659 3547 3687

Add: Premium for LL to passengers @ 235 X

For Eg. If licenced carrying capacity is 50 then 235 x 50= Rs.11750
Carrying Capacity

Tractors/Cranes/Excavators/Tippers/Dumpers etc

TP Premium
TP Premium
Excl.
incl. Coverage
Base TP Coverage for Incl. Paid Driver
Tractors etc for Owner
Premium Owner -Cum- incl. S.Tax
-Cum-Driver
Driver PA
PA Incl.S.Tax
Incl.S.Tax

Misc/ Agr / Commercial Tractors 800 1010 898 1038

Agr / Commercial Trailors 550 617

Page 15 of 32
To
11/04/2021
M/s Varun Motors,
Visakhapatnam.
QUOTATION FOR FIRE SIMPLE RISK

Dwellings, Places of worships, Libraries, Museums, Schools, Colleges, Hospitals

including X-ray and other Diagnostic clinics, Office premises, Meeting Rooms,
Risk Description Auditoriums, Planetarium, Mess Houses, Clubs, Marriage Halls, Showrooms and display
centres where

Building/ Content EARTH QUAKE TERRORISM STFI RSMTD

Contents Zone - IV Non Residential NO NO

SUM
SUM INSURED
INSURED PREMIUM COMPUTATION
FIRE CALCULATION Your Risk Description :-

RATE AMOUNT
100000 (%) (Rs.) Dwellings, Places of worships,
Libraries, Museums, Schools,
RATE : 0.5 50 Colleges, Hospitals including X-ray
Less :- STFI : 0 0 and other Diagnostic clinics, Office
premises, Meeting Rooms,
Less :- RSMTD : 0 0 Auditoriums, Planetarium, Mess
Add :- Earthquake : 0.1 10 Houses, Clubs, Marriage Halls,
Showrooms and display centres
Add :- Terrorism : 0.15 15 where
BASE PREMIUM :- 75
Less :- Commercial Discount : 10 8
NET PREMIUM : 68
Add :Service Tax @ : 12.36 9

FINAL PREMIUM :- 77 77

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
11/04/2021
M/s Varun Motors,
Visakhapatnam.
QUOTATION FOR FIRE STORAGE RISK

Risk Description Storage of Category I hazardous Goods

MATERIAL IN EARTH QUAKE TERRORISM STFI RSMTD

GODOWN Nil Nil NO NO

SUM
SUM INSURED
INSURED PREMIUM COMPUTATION
FIRE CALCULATION Your Risk Description :-

RATE AMOUNT
100000 (%) (Rs.)
RATE : 2.5 250
Less :- STFI : 0 0 Storage of Category I hazardous
Less :- RSMTD : 0 0 Goods
Add :- Earthquake : 0 0
Add :- Terrorism : 0 0
BASE PREMIUM :- 250
Less :- Commercial Discount : 20 50
NET PREMIUM : 200
Add :Service Tax @ : 12.36 25

FINAL PREMIUM :- 225 225

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
11/04/2021
M/s Varun Motors,
Visakhapatnam.
QUOTATION FOR FIRE LONG TERM DWELLING

Shops dealing in goods otherwise not provided for including Laundries, Battery Charging
Risk Description Service Stations, Dry Cleaning, Amusement parks, Hoarding, Neon signs and Sports Galleries,
Outdoor stadiums.

Building/ Content EARTH QUAKE TERRORISM STFI RSMTD NO. OF YEARS

Building Nil Non Residential NO NO 3

SUM
SUM INSURED
INSURED PREMIUM COMPUTATION
FIRE CALCULATION Your Risk Description :-

RATE AMOUNT
100000 (%) (Rs.)
RATE : 1.8 180 Shops dealing in goods otherwise not
Less : Long Term Discount : 15 27 153 provided for including Laundries, Battery
Charging Service Stations, Dry Cleaning,
Less :- STFI : 0 0 Amusement parks, Hoarding, Neon signs and
Less :- RSMTD : 0 0 Sports Galleries, Outdoor stadiums.
Add :- Earthquake : 0 0
Add :- Terrorism : 0.15 15
BASE PREMIUM :- 168
Less :- Commercial Discount : 10 17 15 3
NET PREMIUM : 151 20 4

Add :Service Tax @ : 12.36 19 170 25 5

FINAL PREMIUM :- 170 30 6

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Date : 11/04/2021
Mr. N. Satish,
Visakhapatnam
QUOTATION FOR FIRE SPECIAL PERILS
POLICY

PREMIUM
SUM INSURED
COMPUTATION
RATE AMOUNT
500000 (%) (Rs.)

RATE :
1.5 750
EARTH QUAKE :
0 0

TERRORISM :
0 0
NET PREMIUM :
750
SERVICE TAX : 12.24
92
FINAL PREMIUM :- 842

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
To
Date : 11/04/2021
Mr. N.Satish,
Visakhapatnam.
QUOTATION FOR LONG TERM DWELLING POLICY

SUM PREMIUM
DISCOUNT
DISCOUNT
INSURED COMPUTATION
RATE AMOUNT
Enter here :- 1500000 50 (%) (Rs.)

Enter Years :- 10 RATE :

0.5 3750
EARTH QUAKE :
0.1 1500

TERRORISM :
0 0
NET PREMIUM :
5250
SERVICE TAX : 12.24
643
FINAL PREMIUM :- 5893

Thank You,

For Bajaj Allianz General Insurance Co. Ltd.,

(Authorised Signatory)
BACK FIRE TARIFF (INDUSTRIAL / MANUFACTURING RISK)
Section Risk Rate
Code Code
4 8 5

Earthquake
Zone Rate
1 1
2 0.5
3 0.2
4 0.1
FIRE TARIFF (INDUSTRIAL / MANUFACTURING RISK)
Rate
Description
1.5
Aluminium ,Zinc,Copper Factories
 QUOTATION FOR SHOP KEEPERS PACKAGE POLICY

NAME OF THE DATE OF ISSUE OF

SAMA FANCY EMPORIUM
CUSTOMER : QUOTATION :

SECTION SECTION DESCRIPTION RATE SUM INSURED PREMIUM

SECTION 1 FIRE - BUILDING 2.25 0 0

FIRE - CONTENTS 2.25 0 0

TERRORISM COVER EXTENSION 0.20 0 0

SECTION 2 BURGLARY & HOUSEBREAKING CONTENTS 2.25 0 0

FIRST LOSS BASIS 3.37 0 0

SECTION 3 MONEY INSURANCE 1.50 0 0

SECTION 4 PLATE GLASS 10.00 0 0

SECTION 5 BREAKDOWN OF APPLIANCES ( WINDOW/ SPLIT A/C ) 25.00 0 0

GENERATOR SET 15.00 0 0

OTHER EQUIPMENT 15.00 0 0

BAGGAGE 10.00 0 0

SECTION 6 NEON / GLOW SIGN 10.00 0 0

TERRORISM COVER EXTENSION 0.20 0 0

SECTION 7 ELECTRONIC EQUIPMENTS 10.00 0 0

SECTION 8 FIDELITY GUARANTEE 10.00 0 0

SECTION 9 PERSONAL ACCIDENT 1.50 0 0

SECTION 10 A PUBLIC LIABILITY 0.50 0 0

SECTION 10 B WORKMEN COMPENSATION 4.50 0 0

SECTION 11 BUSINESS INTERRUPTION 2.25 0 0

TERRORISM COVER EXTENSION 0.20 0 0

TOTAL PREMIUM 0
TOTAL( EXCL. SECTION 1,7&11) 0
SECTIONAL DISCOUNT 0 0% 0
NET PREMIUM 0

S.TAX. INCL. ECU. CESS @ 12.24% 12.36% 0

TOTAL AMOUNT PAYABLE 0

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

 QUOTATION FOR OFFICE PACKAGE POLICY

NAME OF THE DATE OF ISSUE OF

CUSTOMER : QUOTATION :

SECTION SECTION DESCRIPTION RATE SUM INSURED PREMIUM

SECTION 1 FIRE - BUILDING 0.50 150000 75

FIRE - CONTENTS 0.50 20000 10

TERRORISM COVER EXTENSION 0.20 0 0

SECTION 2 BURGLARY & HOUSEBREAKING CONTENTS 1.00 0 0

SECTION 3 MONEY INSURANCE 1.50 0 0

SECTION 4 PLATE GLASS 10.00 0 0

SECTION 5 BREAKDOWN OF APPLIANCES 15.00 0 0

SECTION 6 BAGGAGE 10.00 0 0

SECTION 7 ELECTRONIC EQUIPMENTS 10.00 0 0

TERRORISM PREMIUM 0.20 0 0

SECTION 8 FIDELITY GUARANTEE 10.00 0 0

SECTION 9 PERSONAL ACCIDENT 2.00 0 0

SECTION 10 A PUBLIC LIABILITY 5.00 0 0

SECTION 10 B WORKMEN COMPENSATION 0 0

SECTION 11 HOSPITAL CASH 0

SECTIONAL DISCOUNT 1 0% 0

NET PREMIUM 85

S.TAX. INCL. EDU. CESS @ 12.36% 12.36 11

TOTAL AMOUNT PAYABLE 96

NOTE : 1. PLEASE ENTER THE RATES FOR SECTION 1, SECTION 9, SECTION 10B AND SECTION 11 AS PER GUIDELINES
2. SECTION 1 & SECTION 2 ARE COMPULSARY

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

 QUOTATION FOR WORK MEN COMPENSATION

NAME OF THE INSURED : DATE :

RATE
SALARY PER TOTAL NUMBER OF TOTAL SUM RATE NET
DESCRIPTION MONTH NO. MONTHS INSURED %o
ABOVE
PREMIUM
4000
1 12 0 30.00 0.0 0
1 3 0 6.25 2.0 0
1 3 0 67.10 2.0 0
1 3 0 12.15 2.0 0
1 3 0 12.15 2.0 0
1 3 0 67.10 2.0 0
1 3 0 67.10 2.0 0
1 3 0 30.15 2.0 0
1 3 0 30.15 2.0 0
1 3 0 30.15 2.0 0

TOTAL NET PREMIUM 0

SER.TAX INCL. EDU. CESS @ 12.36% 0

TOTAL AMOUNT PAYABLE ! 0

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 QUOTATION FOR MOTER DEALER PACKAGE POLICY

S.NO. DETAILS SECTION SUM INSURED RATE (Permile) PREMIUM

Fire (Buildings) I 1.9 0
1
Fire (Contents) I 3.9 0
2 Burglary II 2.5 0
3 Damage III 15 0
4 Neon Sign IV 10 0
5 Bussiness Interruption V 0 0
6 Breakdown of Bussiness Equip VI 15 0
7 Money Insurance VII 1.5 0
8 Plate Glass VIII 10 0
9 Elec.& Electronic IX 10 0
10 Fedility Guarantee X 7.5 0
11 Public Liablity XIV 5 0
TOTAL : 0 Net Premium :- 0
0
Special Discount @ 0% : 0
0
Service Tax @ 12.36% : 0
Final Premium :- 0

EXCEPT BELOW SEC :- SECTIONAL DISCOUNTS

1 FIRE Upto 5 10%
3 DAMAGE Above 5 15%
9 BREAK DOWN

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
To
Date : 11/04/2021
Mr. N. Sateesh,
Vizag.

QUOTATION FOR PERSONAL ACCIDENT POLICY

RISK 1 :-

RISK - 1
COVER RATE SUM SUM SUM SUM
PREMIUM PREMIUM PREMIUM
INSURED INSURED INSURED INSURED
Principle Spouse Child - 1 Child - 2
BASIC 0.45 0.00 0.00 0.00

WIDER 1 0.00 0.00 0.00

COMPREHENSIVE 1.5 0.00 0.00 0.00

INDIVIDUAL PREMIUM : 0.00 0.00 0.00

Base Premium : 0.00

Add :-Medical Expenses @ 25% : NO 0.00

Add:-Hospital Confinment (Rs.300/-) : NO 0.00

Gross Premium : 0.00

Less :Family discount @ 10 % : NO 0.00 RISK - 1 :-

Net Premium : 0.00 TOTAL PREMIUM PAYABLE : 0

Add :-Service Tax : 12.36% 0.00

FINAL PREMIUM :- 0.00

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 To
Date : 11/04/2021
Mr. N. Sateesh,
Vizag.

QUOTATION FOR PERSONAL ACCIDENT POLICY

PREMIUM
Child - 2
0.00

0.00

0.00

0.00

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 QUOTATION FOR TRAVEL COMPANION

TRAVEL TYPE :- Travel Value USA/CANADA :- Including

DAYS TO TRAVEL 76-90

DOB INDVIDUAL
MEMBER AGE
DD-MMM-YYYY PREMIUM
PROPOSER 25-Aug-1947 0

Note :- WHOLE FAMILY PREMIUM

1) If Additional Family Member PROPOSER 1383
Please Check Their Individual
Premium and entered same SPOUSE 1610
into whole family table to get
Net Premium Payable
CHILD 1
CHILD 2
2) Travel Age Must be between
61 to 70 Yrs. Only NET PREMIUM PAYABLE :- 2993
Travel Value This policy offers high value benefits for the individual traveling abroad. Covers all
medical eventualities including Hospitalization and other incidental expenses with
enhance medical coverage of $5,00,000 and increased limit of $ 1,500 for emergency ca

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 QUOTATION FOR HOUSE HOLDERS PACKAGE POLICY

NAME OF THE DATE OF ISSUE OF

CUSTOMER : QUOTATION :

SECTION SECTION DESCRIPTION RATE SUM INSURED PREMIUM

SECTION 1 FIRE - BUILDING 0.50 0
FIRE - CONTENTS 0.50 0
TERRORISM PREMIUM 0.30 0
SECTION 2 CONTENTS - BURGLARY 2.25 0
FIRST LOSS BASIS 3.37 0
SECTION 3 JEWELLERY & VALUABLES 10.00 0
SECTION 4 PLATE GLASS 10.00 0
SECTION 5A BREAKDOWN OF DOMESTIC APPLIANCES (NON A/C) 2.50 0
SECTION 5B WINDOW AIRCONDITIONER INCLUDING SPLIT UNITS 10.00 0
SECTION 6 ELECTRONIC EQUIPMENTS 10.00 0
TERRORISM PREMIUM 0.30 0
SECTION 7 PEDAL CYCLES 10.00 0
SECTION 8 BAGGAGE 7.50 0
SECTION 9 PERSONAL ACCIDENT 1.50 0
SECTION 10 A PUBLIC LIABILITY 0.50 0
SECTION 10 B WORKMEN COMPENSATION 0

TOTAL PREMIUM EXCLUDING SECTION 1 0

SECTIONAL DISCOUNT 0 0% 0
NET PREMIUM 0

S.TAX. INCL. ECU. CESS @ 12.24% 12.36% 0

TOTAL AMOUNT PAYABLE 0

NOTE : 1. PLEASE ENTER THE RATES FOR SECTION 9 AND SECTION 10 B AS PER GUIDELINES
2. SECTION 1 & SECTION 2 ARE COMPULSARY

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 QUOTATION OF HEALTH GUARD INSURANCE

MEMBER DETAILS DOB AGE SUM INSURED

(DD-MMM-YYYY)

Proposer 10-Jan-1979 42 100000

Spouse 10-Jan-1981 40 100000
Child 10-Jan-2000 21 300000
Child 10-Jan-2002 19 300000
Employee 10-Jan-2002 19 150000

Loading (%) 11809

SMOKER NO 0 0
ASTHAMA PATIENT NO 0 0

BASE PREMIUM 11809

FAMILY DISCOUNT ** Y
NET PREMIUM 11219
SERVICE TAX @ 12.36 % 1387

TOTAL AMOUNT PAYABLE 12606

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)
 QUOTATION FOR HOSPITAL CASH INSURANCE

MEMBER DETAILS DOB AGE SUM INSURED

DD-MMM-YYYY
30 DAYS :- Proposer 6-Oct-1973 48 2000
Spouse
Child2
Spouse
Child1

60 DAYS :- Proposer
Spouse
Child2
Child3
Child3

BASE PREMIUM 1700

FAMILY DISCOUNT ** Y
NET PREMIUM 1615
SERVICE TAX @ 12.24 % 198

TOTAL AMOUNT PAYABLE 1813

Thank you,

For Bajaj Allianz General Insurance. Ltd.,

(Authorised Signature)