MOTOR COVER NOTE
RISK NOTE NO : 553 STICKER NO : 24001-07544-20317
The policyholder described in the Certificate below having proposed for insurance in respect of the Motor Vehicle described in the Certificate and having
paid the sum of 1,499,190.00 TZS (Incl. VAT), ONE MILLION FOUR HUNDRED NINETY-NINE THOUSAND ONE HUNDRED NINETY TANZANIAN SHILLINGS
as premium.
The risk is hereby held covered in terms of the company's usual form of Comprehensive Policy applicable thereto for the period between the dates
specified in the Certificate unless the cover be terminated by the Company by notice in writing in which case the insurance will thereupon ceases and a
proportionate part of the annual premium otherwise payable for such insurance will be charged for the time the Company has been on risk. The
Policyholder warrants that the Motor Vehicle is only used for the purpose of Private-Comprehensive.
Insured Name KOUDIJS ANIMAL NUTRITION TANZANIA TIRA Cover Note 10624-07572-39417
LIMITED Policy No P/301/1002/2024/007065
Account KOUDIJS ANIMAL NUTRITION TANZANIA LIMITED Customer Tax Invoice
Address P.O BOX 71748 DAR ES SALAAM Debit No 531 File No
TIN: 139430727,
Insurer Name Jubilee Allianz General Insurance Company of Intermediary : Pro Trust Insurance Agency
Tanzania Limited
Cover Period From 15-Mar-2024 5:12PM To 14-Mar-2025
THE MOTOR VEHICLES INSURANCE ACT,1961(CAP 169 R.E. 2002)(SECTION-7) VALIDITY OF THIS RISK NOTE IS SUBJECT TO RECEIPT OF Premium BY PRIOR
AND THE MOTOR VEHICLES (THIRD PARTY RISKS) DECREE 1953 (ZANZIBAR) - INSURER TO INCEPTION OF RISK & SUBJECT TO REALIZATION OF CHEQUE,
SECTION 6 WHEREVER APPLICABLE.
CERTIFICATE OF INSURANCE : We hereby certify that a Policy of Insurance covering the liabilities required to be covered by the above mentioned legislations has been
issued as follows:
Loading : 10.00% Excess Buy-Back, Accessories Sum Insured : 0.00
Vehicle Make/Model Type/Color Engine No. Chassis No. Seating
Registration No. Capacity
T457ECC Toyota RAV 4 SUV /White 2AZEAA914822 ACA365019570 5
CC Year of Vehicle Sum Net Premium VAT Amount Premium ([Link])
Manufacture Insured (in TZS) (in TZS)
2360 2008 33,000,000.00 1,270,500.00 228,690.00 1,499,190.00
Date of Issue : ISSUED BY, FRANK P. MWAPILINDA
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15-Mar-2024
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AUTHORIZED SIGNATORY
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IMPORTANT: In the event of any change of vehicle or ownership, this certificate must be returned to the company within 7 days from the date of change.
Makumbusho, City: DarEsSalaam
Powered from Smart Policy Insurance System UIN # Pro553 Receipt No: 109262 Frank P. Mwapilinda-17-Mar-2024 [Link] PM Page 1 of 2
Risk Note No. Sticker No. Insured Name Issuing Intermediary Name
553 24001-07544-20317 KOUDIJS ANIMAL NUTRITION Pro Trust Insurance Agency
TANZANIA LIMITED
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Powered from Smart Policy Insurance System UIN # Pro553 Receipt No: 109262 Frank P. Mwapilinda-17-Mar-2024 [Link] PM Page 2 of 2
