DP 790457

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RENEW AL NOTI CE

Date of Advice: June 19, 2023 Line of Insurance: DUAL PURPOSE BODY

Policy for Renewal: DPB-DP790457 Expiry Date: August 25, 2023


Assured: MR. NAIRE BACARISAS HAMPAC
8111-C KABIHASNAN SAN DIONISIO PARANAQUE CITY 1700

Insured Unit : 2014 MITSUBISHI MONTERO Premium


2.5 SPORT GLS-V 4X2 A/T
Net Premium PHP 8,127.50
Plate Number : AAZ2546 Doc. Stamps 1,016.50
Coverage : OWN DAMAGE 457,000.00 EVAT 975.30
THEFT 457,000.00 Local Government Tax 16.26
VTPL - BODILY INJURY 500,000.00
VTPL - PROPERTY DAMAGE 500,000.00 TOTAL PHP 10,135.56
AUTO PERSONAL ACCIDENT 350,000.00
24-HOUR ROADSIDE ASSISTANCE

Remarks : Mortgagee :
Per IC Circular 2021-54, we would like to
inform that you may extend the period of your
policy cover to synchronize with the month of
your vehicle registration, as per last digit
Agency Code/Source/Source Ext/Mkt Officer:
of your plate number.
202588 SA /HO/ROTAP, M.R.
-/-00509139/ALCAYDE, MIA ALAINE

Reference No.: 2020-8688-0790-4574

Dear Policy Holder,


Your insurance coverage described above expires on the date indicated. As stipulated in Section 77 of the Insurance Code, renewal of your
policy is conditioned on your payment of the renewal premium and cost of documentary stamps and taxes related to your premium on or before the expiry
date. We are sure that you would like to continue to be protected. If you wish to be covered without interruption, you may pay your check to BPI/MS
Insurance Corporation through your agent or at any BPI or BPI Family Bank branch or return to us this advice duly signed by mail or by fax, with your
payment on or before the date of expiry. For expired policies however, coverage will take effect on the date of payment. Above renewal quotation is
valid for 30 days from the date of expiry. Please take note that BPI/MS reserves the right to impose a surcharge on the renewal of policies
incurring loss(es) from the date of this letter until policy expiration.
Should you have any questions, you may contact your agent or BPI/MS HEAD OFFICE at 8840-9000. If you want to fax your renewal
instructions, you may use .

Payment Instruction
1. When paying through the bank, please use the deposit slip for Special Banking Arrangements (SBA) and indicate the correct BPI/MS
Insurance Account Number as follows:
a. If through BPI 0011-1447-72
b. If through BPI Family Bank 6001-0515-02
2. Please indicate 2020-8688-0790-4574 as REFERENCE NUMBER in the deposit slip.
3. Your validated deposit slip will serve as your proof of payment.
4. The Official Receipt will be mailed to you within one (1) week from date of deposit.

RENEWAL INSTRUCTIONS
FOR OFFICE USE ONLY
Assured: MR. NAIRE BACARISAS HAMPAC
SALES
Policy for Renewal: DPB-DP790457 Reference No.: 2020-8688-0790-4574 Renewed by/
Date:
Please renew at expiry date
Approved by/
Enclosed is a check Bank/Branch Name
Signature of Insured/Intermediary Date:
Check no. Checked by/
Amount Date:
Remarks: Date Remarks:
THANK YOU FOR CHOOSING BPI/MS INSURANCE

01-01/RET

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