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rajaexp@gmail.com
09840364573
23145643
16/01/2014
31/01/2015
kumar dev
State
TAMIL NADU
City
CHENNAI
Pin Code
600024
Email address
raviraj@gmail.com
Mobile number
9868578748
Occupation
BUSINESS
Type of Vehicle *
MOTORISED-TWO WHEELERS
Type of Policy
PACKAGE POLICY
RTO Zone
Zone A - Ahmedabad, Bangalore, Chennai, Hyderabad , Kolkata, Mumbai, New Delhi and Pune.
City of Purchase
CHENNAI
Manufacturer Name *
HONDA SCOOTER
Model *
ACTIVA
Variant *
DLX
109
09/01/2014
09/01/2014
No
Type of Fuel
NA
No
No
NA
No
Registration Number
NA
No
Item Name
NA
Cost
NA
Manufacturer's Name
NA
No
No
Number of employee(s)
NA
No
NA
No
Value
NA
Description
NA
No
NA
http://www.orientalinsurance.org.in/BuyNewWeb/faces/CaptureCustDetails.jsp
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1/31/2015
NA
NA
NA
NA
NA
Organisation Name
NA
Membership number
NA
Member Declaration
NA
No
609
514
Service Tax
139
Premium
1262
39617
01/02/2015
31/01/2016
TAMIL NADU
City/Town
CHENNAI
Branch/Office
DO 4 CHENNAI
TN-09-SB-1421
Engine Number *
5674362511
Chassis Number
8740234532
Color *
Metallic BROWN
No
Hypothecation Type *
NA
Name of Company
NA
Address of Company
NA
State
NA
City
NA
Pin Code
NA
NCB declaration*
I/ we declare that the rate of NCB claimed by me/us is correct and that no claim has arisen in the expiring policy period (copy of the policy enclosed). I/ We further undertake that if
this declaration is found to be incorrect, all benefits under the policy in respect of Section I of the Policy will stand forfeited.
I also undertake that the name, address, telephone number of my/ our current insurer, the policy number, type of cover and policy period supplied by me/ us in proposal form on
the portal of The Oriental Insurance Company Limited are correct and true to the best of my knowledge and in the event of the same being found incorrect, it will be treated as
misrepresentation of material fact on the proposed policy and as such all the benefits under the policy in respect of Section I of the Policy will stand forfeited. I also undertake to
preserve the existing policy and to produce the same to the OIC for verification on demand.
Declaration *
I/we hereby declare that the statement made by me/us in this proposal form is true to the best of my/our knowledge and belief and I/we hereby agree that this declaration shall
form the basis of the contract between me/us and the OICL. I/we also hereby declare that if any additions or alterations are carried out after the submission of this proposal form
then the same would be conveyed to the insurer immediately. I/we also understand that if any incorrect details are entered , the claim may not be awarded.
Agree
Back
Disagree
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