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    REPORT01 - N Gtairo260724 103506

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    doreen

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    © All Rights Reserved
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    REPORT01 - N Gtairo260724 103506

    Uploaded by

    doreen
    7 views2 pages

    Original Title

    REPORT01_N-gtairo260724-103506

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    7 views2 pages

    REPORT01 - N Gtairo260724 103506

    Uploaded by

    doreen

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    QUOTATION

    Client Name SEIF ZAHRAN SULEIMAN Quotation No CIBQ2024038559


    Mobile No +255684717474 Issue Date 26-Jul-2024
    Email ID Branch TEMEKE BRANCH
    Address DSM Intermediary Name CRDB Bank PLC
    TIN Insurance Company Alliance Insurance Corporation Ltd.
    VRN Cover Period 27-Jul-2024 - to - 26-Jul-2025

    Insurance Type Motor First Loss Payee

    Insured Name Taxation Gross Premium


    S/N Cover Description Sum Insured Net Premium
    (in TZS)

    Thirdparty Only
    1 SEIF ZAHRAN SULEIMAN Cover Type : Thirdparty Only Sum Insured : 0.00 100,000.00 VAT : 18,000.00 118,000.00
    Reg No : T563CYS Other Fees : 0.00 Levy : 0.00
    Make : Toyota Stamp Duty : 0.00
    Model : NOAH Policy Fund : 0.00
    Chasis No : AZR650012815
    Body Type : STATION WAGON
    Colour : Pearl
    Reg Year : 2002

    Tanzanian Shillings Total : 118,000.00


    Admin Fee : 0.00
    Total Receivable: 118,000.00
    TZS, ONE HUNDRED EIGHTEEN THOUSAND ONLY

    Bank Details Digital Payment

    Scope Of Cover

    Accidental loss or damage to Third parties Motor Vehicles and/or death, bodily injury or loss or damage to property of third parties.

    General Terms & Conditions

    The liability schedule is attached herewith.


    ISSUED BY, GODFREY TAIRO

    For, CRDB Bank PLC

    Powered from Smart Policy Insurance System Page 1 of 2


    Printed Date7/26/2024 Printed Time10:35:07AM Printed By: Godfrey Tairo
    Customer Declaration
    1. I/We declare that the above quote is given to me/us on the information provided by me/us.
    2. I/We declare to the best of my/our knowledge and belief that the information given on this quote is true in every respect.
    3. I/We agree that this proposal and declaration shall be the basis of the contract between me/us and the Insurer.
    4. I/We confirm to have been given adequate pre-sale and post-sale advice relating to coverage, terms and conditions of this
    insurance product.
    _______________________________ _________________________________
    Signature Date

    CRDB Bank PLC


    CUSTOMER CONSENT FORM

    Name of the Insured:

    .............................................................................................................................
    Mobile Number:
    .............................................................................................................................

    Insurance company of your choice (tick one that apply)

    O Alliance Insurance Corporation Ltd. ( )

    O Alliance Life Assurance Limited ( )

    O Britam Insurance (Tanzania) Limited ( )

    O CRDB Insurance Company Limited ( )

    O Jubilee Health Insurance Company (T) Limited ( )

    O National Insurance Corporation (T) Limited ( )

    O Sanlam General Insurance (Tanzania) Limited ( )

    O Sanlam Life Insurance (Tanzania) Limited ( )

    O Strategis Insurance (T) Limited ( )

    O Zanzibar Insurance Corporation ( )

    O ZIC TAKAFUL COMPANY LIMITED ( )

    I ……………………………………………………...................................……., hereby confirm that I have read and understood


    the terms and conditions of the insurance policy I intend to purchase through CRDB Bank PLC, who acts as an agent of the
    insurer I intend to purchase the policy from, I also understand that CRDB Bank PLC is not liable to pay any claims on behalf of
    the insurer and that all premiums are paid directly to the insurer’s nominated bank Account held in CRDB Bank PLC.I confirm
    further that I have not been obligated to open a bank account for the purpose of this insurance policy.

    I hereby voluntarily provide informed consent to CRDB Bank PLC,its Group, my preferred insurance company, and their
    associated partners to use my special personal information for the purpose of underwriting, policy administration,analysis and
    providing future product suggestions.

    Client signature; ……………………..… Date; ……..………………………

    FOR OFFICIAL USE ONLY

    TEMEKE BRANCH, P.O.BOX 1130, DAR ES SALAAM.

    Powered from Smart Policy Insurance System Page 2 of 2


    Printed Date7/26/2024 Printed Time10:35:07AM Printed By: Godfrey Tairo

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