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    MyCar 6030540692 Daniel Staniloaie

    Uploaded by

    Daniel Staniloaie
    This document is a request for insurance and insurance offer from Allianz-Ţiriac for Daniel Staniloaie. It provides details about the policyholder, vehicle, and proposed insurance coverage and pricing. The offer is for third-party liability (RCA) insurance, with an optional "Confort" package that provides additional benefits. The total proposed premium is 1,050 RON for a 12-month policy effective May 18, 2022 to May 17, 2023. Discounts and commissions are also specified. The client's acceptance of the terms is requested at the bottom.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    MyCar 6030540692 Daniel Staniloaie

    Uploaded by

    Daniel Staniloaie
    8 views3 pages
    This document is a request for insurance and insurance offer from Allianz-Ţiriac for Daniel Staniloaie. It provides details about the policyholder, vehicle, and proposed insurance coverage and pricing. The offer is for third-party liability (RCA) insurance, with an optional "Confort" package that provides additional benefits. The total proposed premium is 1,050 RON for a 12-month policy effective May 18, 2022 to May 17, 2023. Discounts and commissions are also specified. The client's acceptance of the terms is requested at the bottom.

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    MyCar 6030540692 Daniel Staniloaie (1)

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    © © All Rights Reserved

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    This document is a request for insurance and insurance offer from Allianz-Ţiriac for Daniel Staniloaie. It provides details about the policyholder, vehicle, and proposed insurance coverage and pricing. The offer is for third-party liability (RCA) insurance, with an optional "Confort" package that provides additional benefits. The total proposed premium is 1,050 RON for a 12-month policy effective May 18, 2022 to May 17, 2023. Discounts and commissions are also specified. The client's acceptance of the terms is requested at the bottom.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    8 views3 pages

    MyCar 6030540692 Daniel Staniloaie

    Uploaded by

    Daniel Staniloaie
    This document is a request for insurance and insurance offer from Allianz-Ţiriac for Daniel Staniloaie. It provides details about the policyholder, vehicle, and proposed insurance coverage and pricing. The offer is for third-party liability (RCA) insurance, with an optional "Confort" package that provides additional benefits. The total proposed premium is 1,050 RON for a 12-month policy effective May 18, 2022 to May 17, 2023. Discounts and commissions are also specified. The client's acceptance of the terms is requested at the bottom.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

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    UHFRPDQGăPVăWHDGUHVH]LUHSUH]HQWDQWXOXLWăXGHYkQ]ăUL3UH]HQWDRIHUWăLQFOXGHSURGXVXODGHFYDWQHYRLORUVLFHULQĠHORUWDOH

    Cerere de asigurare Auto


    6HULHFDOFXODĠLH6030540692
    ,QIRUPDĠLLGHVSUHSURSULHWDUXOXWLOL]DWRUXOYHKLFXOXOXL
    1XPHúLSUHQXPH Staniloaie Daniel
    Proprietar CNP 1900419420031
    -XGHĠXOúLORFDOLWDWHDGHUHɁHGLQĠă Bucuresti, Bucuresti,
    ,QIRUPDĠLLGHVSUHDVLJXUDUH
    'DWDLQWUăULLvQYDODELOLWDWH 18/05/2022
    Perioada de asigurare 12 luni, de la 18/05/2022 la 17/05/2023
    5HvQQRLUHSROLĠDQU 117296617 -
    )UHFYHQĠDGHSODWăDSROLĠHLGHDVLJXUDUH integral -
    Rca Casco
    Moneda în care se va îQFKHLDSROLĠDGHDVLJXUDUH RON -
    ,QIRUPDĠLLGHVSUHYHKLFXO
    1XPăULGHQWLILFDUHVHULHGHúDVLX U5YPK816HLL833785
    1XPăUvQPDWULFXODUHQXPăUvQUHJLVWUDUH B916DNY
    Categorie Autoturism Model Tip Sportage (QL)(2016->)
    Marca Kia Versiune Versiune
    0DVDPD[LPăDXWRUL]DWă 2200 1XPăUGHORFXUL 5
    &DSDFLWDWHFLOLQGULFă 1591 Putere 130
    Sursa de energie Benzina $QIDEULFDĠLH 2019
    .0vQUHJLVWUDĠLODERUGXOYHKLFXOXOXL 1753 6XPDDVLJXUDWăDYHKLFXOXOXL 0
    9DORDUHDWRWDOăDGRWăULORUVXSOLPHQWDUH 0
    Istoricul daunelor RCA
    &ODVD%0LQLĠLDOăFRQIRUP&('$0 B0
    1XPăUGHGDXQHGLQDQXODQWHULRULQWUăULLvQYDODELOLWDWH 0
    &ODVD%0UH]XOWDWă B1
    ,QIRUPDĠLLSULYLQGYHKLFXOXOXWLOL]DUHD
    Vehiculul este înmatriculat în România
    9HKLFXOXOHVWHFRQGXVGHRSHUVRDQăFXYkUVWDGHSkQăvQDQL LQFOXVLY DOWDGHFkW$VLJXUDWXO" Nu
    9HKLFXOXODIRVWDFKL]LĠLRQDWFXXQQXPăUGHFKHLFDUGXULSHFDUHSURSULHWDUXOOHGH‫܊‬LQHvQSUH]HQW 0
    9HKLFXOXOHVWHFRPHUFLDOL]DWGHXQGHDOHUUHSUH]HQWDQĠăGLQ5RPkQLDúLXUPHD]ăVăILHvQPDWULFXODWvQUHJLVWUDW" Nu
    9HKLFXOXOHVWHXWLOL]DWvQDFWLYLWDWHDGHWD[LPHWULHUHQWDFDUúFRDOăGHúRIHULSD]ăúLSURWHFĠLH" Nu
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    'HFODUFăDPIRVWLQIRUPDWFXSULYLUHODSUHOXFUDUHDGDWHORUFXFDUDFWHUSHUVRQDOGHFăWUH$OOLDQ]ğLULDFúLDPSULPLW1RWLILFDUHDSULYLQGSUHOXFUDUHD
    datelor cu caracter personal (detalii suplimentare pe https://www.allianztiriac.ro/ro_RO/aspecte-legale.html ).
    'HFODUFăDPSULPLWWRDWHLQIRUPD‫܊‬LLOHSUHFRQWUDFWXDOHLQFOXVLYGRFXPHQWXOGHLQIRUPDUHFXSULYLUHODSURGXVXOGHDVLJXUDUH 3,' ‫܈‬L*KLGGH
    EHQHILFLLDVLJXUDUHDXWR*%$YPDUFDUHFXSULQGHFRQGL‫܊‬LLOHGHDVLJXUDUH

    &DSLWDOVRFLDOVXEVFULVúLYăUVDWOHL
    6&$OOLDQ]ğLULDF$VLJXUăUL6$
    Înregistrat la ORC sub nr. J40/15882/1994, CUI: 6120740
    6WU&ăGHUHD%DVWLOLHLQU
    6RFLHWDWHDXWRUL]DWăGH$XWRULWDWHDGH6XSUDYHJKHUH)LQDQFLDUă
    Sector 1%XFXUHúWL010616, România &RGXODORFDWvQ5HJLVWUXODVLJXUăWRULORUúLUHDVLJXUăWRULORU5$
    Telefon 021 2082 222 Codul LEI 529900XKNXM9MBH8GS45
    Fax 021 2082 211 Operator de date cu caracter personal nr. 779
    www.allianztiriac.ro EN ISO 9001

    &ODVLILFDUH&RQILGHQĠLDO
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    Acoperiri RCA Confort

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    'HFRQWDUHGLUHFWă 2S‫܊‬LRQDO 2S‫܊‬LRQDO
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    15,000 RON

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    %D]ă
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    %D]ă
    'HFHV,QYDOLGLWDWHWHPSRUDUă 5,000 RON
    ,QYDOLGLWDWHSHUPDQHQWăWRWDOă 10,000 RON

    Prima de asigurare - Cost Total RCA Confort

    RON (RCA) 984 RON 1050 RON


    EUR (Casco)

    Detalierea primelor de asigurare RCA Confort

    5ăVSXQGHUHFLYLOăDXWR 5&$ 984 RON 984 RON


    3URWHF‫܊‬LHMXULGLFă - 20 RON
    $VLVWHQĠăUXWLHUă - 30 RON
    Accidente Persoane - 16 RON

    Tip Reducere RCA

    Reduceri aplicate pentru 5HGXFHUHFRPHUFLDOă 0 RON


    pachetul selectat Reducere pachet -52 RON
    5HGXFHUH&RPXQLFDUH(OHFWURQLFă 0 RON
    Total -52 RON
    Comisionul de intermediere inclus în prima RCA Confort
    GHDVLJXUDUHDIHUHQWă
    SROLĠHL5&$úLDFRSHULULORUDVRFLDWHDFHVWHLD
    YDORDUHDDEVROXWă VH 118.08 118.08
    GHWHUPLQăSULQDSOLFDUHDSURFHQWXOXLDVXSUD RON RON
    primei de asigurare (12 %) (12 %)

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    DVLJXUDUHúLDUHODED]ăRS‫܊‬LXQLOHWDOHGHDVLJXUDUH
    Emiterea politei de asigurare este conditionata de existenta sau furnizarea numarului de telefon mobil si a adresei de e-mail valide,
    declarate de Contractant.
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    vQIRWRJUDILLOHHIHFWXDWHvQFDGUXOLQVSHFĠLHLGHULVFVDXDXIRVWPHQĠLRQDWHvQSROLĠDGHDVLJXUDUHGDFăQXDXIRVWFRQVWDWDWHGH$OOLDQ]
    ‫܉‬LULDFFDILLQGUHSDUDWHSULQHIHFWXDUHDXQRUIRWRJUDILLvQFDGUXOXQHLQRLLQVSHFĠLLGHULVF
    x3R‫܊‬LRSWD‫܈‬LSHQWUXFODX]D'HFRQWDUHGLUHFWă±prima de asigurare 168 RON

    Client / Solicitant Agent / Broker $OOLDQ]ğLULDF$VLJXUăUL6$


    Staniloaie Daniel Security Insurance - Agent De Drumul Taberei_v1 - Ditu Bogdan
    Asigurare Srl (RAJ505131)
    -1900419420031-

    1XPH3UHQXPH6HPQăWXUD 'HQXPLUHFRG$6)6HPQăWXUD $JHQĠLD1XPHUHSUH]HQWDQW6HPQăWXUD

    6&$OOLDQ]ğLULDF$VLJXUăUL6$ &DSLWDOVRFLDOVXEVFULVúLYăUVDWOHL
    6WU&ăGHUHD%DVWLOLHLQU Înregistratla ORC sub nr. J40/15882/1994, CUI:6120740
    Sector 1%XFXUHúWL010616, România 6RFLHWDWHDXWRUL]DWăGH$XWRULWDWHDGH6XSUDYHKHUH)LQDQFLDUă
    Telefon 021 2082 222 &RGXODORFDWvQ5HJLVWUXODVLJXUăWRULORUúLUHDVLJXUăWRULORU5$
    Fax 021 2082 211 Codul LEI 52990XKNXM9MBH8GS45
    www.allianztiriac.ro Operatorul de date cu caracter personal nr. 779
    SR EN ISO 9001

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