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73 views3 pages

Index

Uploaded by

irshad55033
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MOTOR VEHICLE INSURANCE - QUOTATION ‫عرض أسعار تأمين المركبات‬

Thank you for insuring your vehicle with us. ‫شكرا لتأمين سيارتك معنا‬
QUOTE BASIC DETAILS ‫أساسيات عرض‬

Quote Number Q/10/1306063 ‫رقم عرض السعار‬

Quote Date 14/November/2024 ‫تاريخ اصدار عرض السعار‬

Broker Name ‫اسم الوسيط‬

INSURED DETAILS ‫تفاصيل المؤمن له‬

Insured Name Black Line Gen Tr Co ‫اسم المؤمن له‬

Date of Birth ‫تاريخ الميلد‬


Emirates ID
Mobile Number 0504232228 ‫رقم الهاتف المحمول‬
Email [email protected] ‫البريد اللكتروني‬

VEHICLE DETAILS ‫تفاصيل السيارة‬

Model Year 2017 ‫سنة الصنع‬

Make & Model TOYOTA HIACE STANDARD ‫النوع و الموديل‬

Body Type PANEL VAN ‫نوع هيكل السيارة‬

Seating capacity 3 ‫عدد الركاب‬


Color White ‫اللون‬
Plate Number 71064 ‫رقم اللوحة‬
Chassis Number JTFPX22P6H0075787 ‫رقم الشاسيه‬
Engine Number 9119386 ‫رقم المحرك‬
Sum Insured AED 50,000.00 /- ‫القيمة التأمينية‬

Vehicle Specification GCC ‫مواصفات السيارة‬


Purpose of Use PRIVATE ‫صفة الستعمال‬

PREMIUM & DEDUCTIBLE ‫القتطاعات و القسط التأمي ن‬

Cover Type Comprehensive ‫نوع التغطية التأمينية‬

Basic Deductible AED 350.00 /-


( ‫القتطاعات الساسية )فالستهلك والتح‬
Premium AED 1,750.00 /- ‫القسط التأميني‬

VAT 5 % AED 87.50 /- %5 ‫الضريبة‬


Premium (Incl of VAT) AED 1,837.50 /- ( ‫شامل ضريبة القيمة المضافة‬ ) ‫قسط التأمين‬

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STANDARD COVERS LIMIT ‫الحد القصى‬ ‫التغطية الموحدة‬

Agency Repairs NO-ASNIC approved garages Agency Repairs

Personal accident benefit for driver YES-LIMITED AED 200,000 Personal accident benefit for driver

Personal accident benefit for YES-LIMITED AED 200,000 Personal accident benefit for passenger
passenger
Loss or Damage to the Insured YES Loss or Damage to the Insured Vehicle
Vehicle
Third Party Liability YES Third Party Liability

Third Party Liability to family YES Third Party Liability to family members
members
Fire & Theft Cover YES Fire & Theft Cover

Road side assistance (recovery NO Road side assistance (recovery service)


service)
Rent a Car(max. 7 days,optional for NO Rent a Car(max. 7 days,optional for
AED100) AED100)

Oman coverage additional premium NO Oman coverage additional premium

Third Party Property Damage AED 2,000,000 Third Party Property Damage

Important Notes:
• Validity of Quote: 15 Days from the date of issue.
• Quotation would be subject to revision by the insurer in case of any changes in the information provided.
• As per UAE Ministry guidelines, at the time of an accident, if the driver is less than 25 years of age & driving experience
less than 1 year,an additional policy excess of 10% of the claim amount will be applicable in addition to the excess stated
above.
• Premium payments can be made by cash, cheque. In case of cheque payments, Cheque should be issued in favour of t
insurance

All other terms and conditions as per the standard policy and endorsement wordings of the insurer. We trust the terms
would meet your requirements and now look forward to your confirmation.

Thank You,
Retail Department
Al Sagr National Insurance Company
CUSTOMER DECLARATION
I declare that to the best of my knowledge and belief, the answers given are true and all material has been disclosed. I
confirm the payment of the premium is made from my own source

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Prepared By
Al Sagr Insurance - AUTHORISED SIGNATURE

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