1. The document is a contract finalization letter from an insurance company to Mr. Parkash Singh Dangwal regarding an extended warranty policy. It provides details of the insured asset (an LED TV), coverage period of 2 years, and a premium of Rs. 1808. 2. The letter requests Mr. Dangwal to confirm the details are correct within 15 days, and warns that any incorrect or omitted information could void the policy. 3. Contact information is provided for any objections or changes to the information.

1. Dear MR PARKASH SINGH DANGWAL,
We wish to inform you that the contract under policy number OG-16-1000-6609-00536958 has been finalized based on the information and declaration given by you, the transcript
where of is mentioned below. You are requested to reconfirm the same. In case of any disagreement or objection or any changes with respect to information mentioned below, we
request you to please revert back within a period of 15 days from date of your receipt of this, failing which it will be deemed that you are satisfied with the correctness of the details
mentioned below. Kindly note that as the contents and declarations contained in this transcript is the basis on which we have issued the policy to you. We advise you to please ensure
that you have provided/disclosed and or not withheld any material facts/information and declarations, as Policy becomes Void ab initio if material facts are not provided/disclosed
and or withheld and in such case no claim, if any, will be considered by us apart from forfeiture of the premium.
Details provided by you:
A. Proposer details:
1. Proposer Name : MR PARKASH SINGH DANGWAL
2. Proposer Address : H.NO.197 ST.NO.11 BACHAN SINGH NAGAR,BANK COLONY,HAIBOWAL KALAN, LUDHIANA - 141001,PUNJAB
3. Proposer Contact Number : 9815602814
4. Proposer e-mail id : PARKASHD11@GMAIL.COM
B. Asset details:
Asset Category Manufacturer Make Model
LED SAMSUNG ELECTRONICS INDIA LIMITED SAMSUN-LED 32J4300
Manufacturer's Product Warranty Period Insured Asset Serial No Insured Asset Invoice No Invoice Date Sum Insured (in Rs.)
1 YEAR 0A263ZEGA03506 1712 09-NOV-2015 29500
C. Coverage opted:
1 Period of Extended Warranty 2 year(s)
2 Period of Insurance From 09-NOV-2016 00:00 Hours To 08-NOV-2018
3 Total Premium (including Service Tax and Swachh Bharat/Edu.Cess) Rs.1808
4 Deductibles 10% of the claim amount subject to a minimum of Rs. 500 in respect of each and every claim
In case of Disagreement or objection or any changes with respect to information and contents mentioned hereinabove, please contact our toll free number & register your
objections/changes/disagreement to the contents of this transcript or you may also send us email or written correspondence at the following details within a period of 15 days from
date of your receipt of this transcript along with Policy:
I/we have read and understood the Privacy Policy of your Company at www.bajajallianz.com and I hereby unconditionally agree and bind myself to all terms and conditions of your
Privacy Policy, as amended, from time to time.
For Extended Warranty policy related communication :
Toll Free Number : 1800-209-1021 (free calls from all mobiles and landlines) between 11 AM to 11 PM, 7 days a week
E-Mail Address : ew.cda@bajajallianz.co.in
Contact our policy servicing branch at : Bajaj Allianz General Insurance Company Ltd,GE Plaza, Airport Road, Yerawada, Pune-411006. PH: +91 (020) 66026666
(Details are system generated & hence no signature required).
Insurance Act, 1938 Section 41 - Prohibition of Rebates Insurance Act
No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating
to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing
or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the insurer. ANY PERSON MAKING FAULT IN
COMPLYING WITH THE PROVISIONS OF THIS SECTION SHALL BE PUNISHABLE WITH FINE WHICH MAY EXTEND TO FIVE HUNDRED RUPEES.
Schedule (1) | Printed on : 30-May-2016 07:09:10 pm |Silent Print|WEB|31837022
*50358965*
BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED
(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Regd. No.113)
Regd. Office: GE Plaza, Airport Road, Yerwada, Pune 411006 (India)
EXTENDED WARRANTY TRANSCRIPT OF PROPOSAL
Policy Issuing Office GE Plaza,Airport Road,Yerwada,Pune-411006,Phone No :66026666
Insured Name MR PARKASH SINGH DANGWAL Child Certificate Number OG-16-1000-6609-00536958
For help and more information: 2Page 1 of
Contact our 24 Hour Call Centre at 1800-209-5858, 1800-102-5858 (Toll Free)
Email: customercare@bajajallianz.co.in , Website www.bajajallianz.com Corporate Identification Number: U66010PN2000PLC015329
https://www.facebook.com/BajajAllianz https://twitter.com/BajajAllianz www.bit.do/bjazgi Demystify Insurance http://support.bajajallianz.com

2. For & on the behalf
Bajaj Allianz General Insurance Company Ltd. QR Code
Authorized Signatory
INSURED DETAILS POLICY DETAILS
Insured Address
H.NO.197 ST.NO.11 BACHAN SINGH NAGAR,
BANK COLONY,HAIBOWAL KALAN,
LUDHIANA - 141001,
PUNJAB
Policy Issued on 28-NOV-2015
Period of Insurance
From: 09-NOV-2016 00:00
To : 08-NOV-2018 Midnight
Endorsement NA
Customer ID 73411373 Policy Status ISSUED
Master Policy Number OG-12-9999-9960-00000022
Cover Details
ASSET CATEGORY LED
SUM_INSURED 29500
MANUFACTURER SAMSUNG ELECTRONICS INDIA LIMITED
MAKE SAMSUN-LED
MODEL NO 32J4300
MANUFACTURER'S PRODUCT WARRANTY PERIOD 1 YEAR
Premium Details
Final Premium Rupees One Thousand Eight Hundred and Eight only.
Net Premium. Rs.1579
Service Tax Rs.221
Swachh Bharat/Edu.Cess Rs.8
Gross Premium. Rs.1808
Other Details
Insured Asset Serial No 0A263ZEGA03506
Insured Asset Invoice No 1712
Invoice Date 09-NOV-2015
Extended Warranty Kit No 1
Other Term And Conditions As per the Policy Wordings of Extended Warranty
Remarks test
Supplier ID 3513
For Extended Warranty policy related communication :
Toll Free Number : 1800-209-1021 (free calls from all mobiles and landlines) between 11 AM to 11 PM, 7 days a week
E-Mail Address : ew.cda@bajajallianz.co.in
Contact our policy servicing branch at : Bajaj Allianz General Insurance Company Ltd,GE Plaza, Airport Road, Yerawada, Pune-411006. PH: +91 (020) 66026666
Premium Details
Receipt Number:0 | Date:28-NOV-15 | Premium Payer ID:33875185 | Float: BG
** If Premium paid through Cheque, the Policy is void ab-initio in case of dishonour of Cheque.
Financial Institution Ref. No. 426EWC17072082
Agency Code
& Name
10031837,BAJAJ FINANCE
LIMITED
Contact No.
E-Mail ID.
(This is system generated document and need not be countersigned.)
Consolidated stamp Duty paid vide Receipt No: .29 dated 23-OCT-15
Service Tax Regd. Number AABCB5730G-ST-001
Schedule (1) | Printed on : 30-May-2016 07:09:10 pm |Silent Print|WEB|31837022
*50358965*
BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED
(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Regd. No.113)
Regd. Office: GE Plaza, Airport Road, Yerwada, Pune 411006 (India)
EXTENDED WARRANTY POLICY SCHEDULE UIN : BAL-OT-P15-04-V02-15-16
Policy Issuing Office GE Plaza,Airport Road,Yerwada,Pune-411006,Phone No :66026666
Insured Name MR PARKASH SINGH DANGWAL Child Certificate Number OG-16-1000-6609-00536958
For help and more information: 2Page 2 of
Contact our 24 Hour Call Centre at 1800-209-5858, 1800-102-5858 (Toll Free)
Email: customercare@bajajallianz.co.in , Website www.bajajallianz.com Corporate Identification Number: U66010PN2000PLC015329
https://www.facebook.com/BajajAllianz https://twitter.com/BajajAllianz www.bit.do/bjazgi Demystify Insurance http://support.bajajallianz.com