Unified Compulsory Motor Insurance Policy Schedule ‫ﺟ ﺪ و ل اﻟ ﻮﺛ ﯿ ﻘ ﺔ اﻟ ﻤ ﻮ ﺣ ﺪ ة ﻟ ﻠ ﺘﺄ ﻣ ﯿ ﻦ ا ﻹﻟ ﺰ ا ﻣ ﻲ ﻋ ﻠ ﻰ اﻟ ﻤ ﺮ ﻛ ﺒﺎ ت‬

Insurance details ‫ﺑ ﯿﺎﻧﺎ ت اﻟ ﺘ ﻐﻄ ﯿ ﺔ اﻟ ﺘﺄ ﻣ ﯿ ﻨ ﯿ ﺔ‬

Product ID : A-SALM-1-B-08-009 : ‫رﻗﻢ اﻟﻤ ﻨ ﺘﺞ‬
Branch : Tam eeni : ‫اﻟﻔﺮع‬
Policy Num ber : 94/1/249179/2023 : ‫رﻗﻢ اﻟﻮﺛ ﯿﻘﺔ‬
Issue Date and Tim e : 29/09/2023 16:35:16 : ‫ﺗﺎ رﻳﺦ و وﻗﺖ اﻹ ﺻﺪا ر‬
Date\tim e cover start and End : From To : ‫وﻗﺖ ﺑﺪاﻳﺔ وﻧ ﮫﺎﻳﺔ اﻟ ﺘﻐﻄ ﯿﺔ اﻟ ﺘﺄﻣ ﯿ ﻨ ﯿﺔ‬/ ‫ﺗﺎ رﻳﺦ‬
30/09/2023 29/09/2024
Insured Details ‫ﺑ ﯿﺎﻧﺎ ت اﻟ ﻤ ﺆ ﻣ ﻦ ﻟ ﻪ‬
Insured Nam e : ‫ﻋ ﺒﺎس ﷴ ﺻﺎﻟﺢ اﻟ ﻨﺠﺮاﻧﻲ‬ : ‫اﺳﻢ اﻟﻌﻤ ﯿﻞ‬
Date of Birth / Age : 01-07-1388 /55 : ‫ اﻟﻌﻤﺮ‬/ ‫ﺗﺎ رﻳﺦ اﻟﻤ ﯿﻼ د‬
Saudi ID / Iqam a Num ber : 1001947231 : ‫ اﻹﻗﺎﻣﺔ‬/ ‫رﻗﻢ ھﻮﻳﺔ اﻟﻮط ﻨ ﯿﺔ‬
Address : 3205 - 6662-23765 ‫ ﺟﺪة‬- ‫ ﺣﻲ اﻟﺮ ﺣﻤﺎﻧ ﯿﺔ‬- ‫ﻓ ﻀ ﯿ ﻠﺔ اﻟ ﺸ ﯿﺦ ﻋ ﺜﻤﺎ ن ﻟﻄﻔﻲ أﻓ ﻨﺪ ي‬ : ‫اﻟﻌ ﻨﻮا ن‬
Hom e / W ork / Tele No. / Mobile : 0503649047 : ‫ رﻗﻢ اﻟﺠﻮال‬/ ‫ اﻟﻌﻤﻞ‬/ ‫ھﺎﺗﻒ اﻟﻤ ﻨﺰل‬
No.
Insured Vehicle Details ‫ﺑ ﯿﺎﻧﺎ ت اﻟ ﻤ ﺮ ﻛ ﺒ ﺔ اﻟ ﻤ ﺆ ﻣ ﻨ ﺔ‬
Vehicle Brand : ‫ﺗﻮﻳﻮﺗﺎ‬ : ‫ﻣﺎ رﻛﺔ اﻟﻤﺮﻛ ﺒﺔ‬
Vehicle Model : ‫ﻛﺎﻣﺮ ي‬ : ‫طﺮا ز اﻟﻤﺮﻛ ﺒﺔ‬
Vehicle Color : ‫ﻓ ﻀﻲ‬ : ‫ﻟﻮ ن اﻟﻤﺮﻛ ﺒﺔ‬
Vehicle Registration Ex piry Date : 04/06/1446 : ‫ﺗﺎ رﻳﺦ اﻧ ﺘ ﮫﺎء ر ﺧ ﺼﺔ اﻟ ﺴ ﯿﺮ‬
Manufacture Year : 2007 : ‫ﺳ ﻨ ﺔ اﻟ ﺼ ﻨﻊ‬
Vehicle Body Type : : ‫ﻧﻮع ھ ﯿﻜﻞ اﻟﻤﺮﻛ ﺒﺔ‬
Type of Use : ‫ﺷ ﺨ ﺼﻲ‬ : ‫ﻏﺮ ض اﻹﺳ ﺘﺨﺪام‬
Type of Registration : ‫ﺳ ﯿﺎ ر ة ﺧﺎ ﺻ ﺔ‬ : ‫ﻧﻮع ﺗ ﺴﺠ ﯿﻞ اﻟﻤﺮﻛ ﺒﺔ‬
Chassis Num ber : 6T1BE42K47X434262 : ‫رﻗﻢ اﻟ ﮫ ﯿﻜﻞ‬
Plate No. : 5939 ‫ح د م‬ : ‫رﻗﻢ اﻟ ﻠﻮ ﺣﺔ‬
Sequence No. / Custom Card No. : 910690800 : ‫ رﻗﻢ اﻟ ﺒﻄﺎﻗﺔ اﻟﺠﻤﺮﻛ ﯿﺔ‬/ ‫اﻟﺮﻗﻢ اﻟ ﺘ ﺴ ﻠ ﺴ ﻠﻲ‬
Premium Details ‫ﺑ ﯿﺎﻧﺎ ت ﻗ ﺴﻂ اﻟ ﺘﺄ ﻣ ﯿ ﻦ‬
Gross Prem ium : 649.89 : ‫ا ﻟ ﻘ ﺴ ﻂ اﻷ ﺳ ﺎ ﺳ ﻲ‬
No Claim Discount : : ‫ﻗ ﯿﻤﺔ ﺧ ﺼﻢ ﻋﺪم و ﺟﻮ د ﻣﻄﺎﻟ ﺒﺎت‬
Com m ission : 13.26 : ‫اﻟﻌﻤﻮﻟﺔ‬
Vaule added Tax : 99.43 : ‫ﺿﺮﻳ ﺒﺔ اﻟﻘ ﯿﻤﺔ اﻟﻤ ﻀﺎﻓﺔ‬
Final Prm eium : 762.32 : ‫ا ﻟﻘ ﺴ ﻂ ا ﻟ ﻨ ﮫ ﺎ ﺋ ﻲ‬
Conditions ‫اﻟ ﺸ ﺮ و ط‬
Ex clude the cover if the vehicle is driven by a person under the age of 18 ‫ ( ﻋﺎًﻣﺎ ﻣ ﯿﻼ دﻳﺎً ﻣﺎ ﻟﻢ ﻳﻜ ﻦ ھﻮ اﻟﻤﺆﱠﻣ ﻦ ﻟﻪ وﻣﺎ ﻟﻢ ﻳﺮ د‬18 ) ‫ﻳ ﺴ ﺘ ﺜ ﻨﻰ ﻗ ﯿﺎ دة أ ي ﺷﺨ ﺺ ﻳﻘﻞ ﻋﻤﺮه ﻋ ﻦ‬
(according to the Gregorian calendar) unless the said person is the insured .‫ ( ﺳ ﻨﺔ ﻓﻲ ﺟﺪول اﻟﻮﺛ ﯿﻘﺔ‬18 ) ‫اﺳﻤﻪ ﻣ ﻦ أﺳﻤﺎء اﻟ ﺴﺎﺋﻘ ﯿ ﻦ اﻟﻤ ﺴﻤ ﯿ ﻦ اﻟﺬﻳ ﻦ ﺗﻘﻞ أﻋﻤﺎ ر ھﻢ ﻋ ﻦ‬
or is included am ong the nam es of authorized drivers under the age of 18
in the Policy schedule.
The Cover start after 24 Hours from Issuance Date and Tim e and no claim ‫ ﺳﺎﻋﺔ ﻣ ﻦ ﺗﺎ رﻳﺦ و وﻗﺖ إ ﺻﺪا ر اﻟ ﺘﺄﻣ ﯿ ﻦ وﻟ ﻦ ﻳ ﺘﻢ ﻗ ﺒﻮل أ ي ﻣﻄﺎﻟ ﺒﺔ ﻗ ﺒﻞ ﺗﺎ رﻳﺦ و‬24 ‫ﺗ ﺴﺮ ي اﻟ ﺘﻐﻄ ﯿﺔ ﺑﻌﺪ‬
will be entertained before the inception. .‫وﻗﺖ اﻟ ﺴﺮﻳﺎ ن‬
In Case the city of accident is different from Client national address city the ‫ﻓﻲ ﺣﺎل إ ﺧ ﺘ ﻠﻔﺖ ﻣﺪﻳ ﻨﺔ اﻟﺤﺎ دث ﻋ ﻦ ﻣﺪﻳ ﻨﺔ اﻟﻤﺬﻛﻮ رة ﻓﻲ اﻟﻌ ﻨﻮا ن اﻟﻮط ﻨﻲ ﻟ ﻠﻌﻤ ﯿﻞ ﻳﺤﻖ ﻟ ﺸﺮﻛﺔ ط ﻠﺐ‬
com pany has the right to ask for prove of residence at claim processing .‫إﺛ ﺒﺎت اﻟﻌ ﻨﻮا ن اﻟﻮط ﻨﻲ ﻟ ﻠﻌﻤ ﯿﻞ ﻋ ﻨﺪ إ ﺟﺮاءات اﻟﻤﻄﺎﻟ ﺒﺔ‬
tim e
No refund for deletion of vehicle on which claim has been reported. .‫ﻻ ﻳ ﺘﻢ إ ر ﺟﺎع أ ي ﻣ ﺒﺎﻟﻎ ﻣﺎﻟ ﯿﺔ ﻓﻲ ﺣﺎل ﺗﻘﺪﻳﻢ ط ﻠﺐ إﻟﻐﺎء ﻟﻤﺮﻛ ﺒﺔ ﺗﻮ ﺟﺪ ﻋ ﻠ ﯿ ﮫﺎ ﻣﻄﺎﻟ ﺒﺎت‬
All Vehicles used in general transportation or Rent A Car or Lim ousines are ‫أو‬/‫أو ﻣﺮﻛ ﺒﺎت أ ﺟﺮة و‬/‫أو اﻹﻳﺠﺎ ر اﻟ ﯿﻮﻣﻲ و‬/‫ﺟﻤ ﯿﻊ اﻟﻤﺮﻛ ﺒﺎت اﻟﻤ ﺴ ﺘﺨﺪﻣﺔ أو ﻣ ﺴﺠ ﻠﺔ ﻓﻲ اﻟ ﻨﻘﻞ اﻟﻌﺎم و‬
ex cluded from the cover and no claim will be entertained related to this ‫اﻟﻤﺮﻛ ﺒﺎت ﻣ ﺴ ﺘ ﺜ ﻨﺎة ﻣ ﻦ اﻟ ﺘﻐﻄ ﯿﺔ وﻟ ﻦ ﻳ ﺘﻢ ﻗ ﺒﻮل أ ي ﻣﻄﺎﻟ ﺒﺔ ﻣ ﺘ ﺼ ﻠﺔ ﻣﻊ اﻷﻧﻮاع اﻟ ﻨﻘﻞ اﻟﻤﺬﻛﻮ رة أﻋﻼه‬
type of vehicles
Adm in fees of SR. 34.50/- including VAT will be deducted from refund .‫ ﷼ ﺷﺎﻣﻞ ﺿﺮﻳ ﺒﺔ اﻟﻘ ﯿﻤﺔ اﻟﻤ ﻀﺎﻓﺔ ﻋ ﻨﺪ إﻟﻐﺎء اﻟﻮﺛ ﯿﻘﺔ‬34.5 ‫ﻳ ﺘﻢ ﺧ ﺼﻢ رﺳﻮم إ دا رﻳﺔ ﺑﻘ ﯿﻤﺔ ﻣ ﺒ ﻠﻎ‬
prem ium at policy cancelation tim e
This Certificate deem ed Null and void in case of written off .‫ﺗﻐ ﯿ ﯿﺮ ﺑ ﯿﺎﻧﺎﺗ ﮫﺎ‬/ ‫ﺗﻌﺪﻳ ﻠ ﮫﺎ‬/ ‫ﺗﻌ ﺘ ﺒﺮ ھﺬه اﻟ ﺸ ﮫﺎ دة ﻻﻏ ﯿﺔ ﻓﻲ ﺣﺎل ﺗﻢ ﺷﻄ ﺒ ﮫﺎ‬
/Modified/Change.
Valid Driving License at tim e of driving the insured vehicle and Police report ‫و ﺟﻮ د ر ﺧ ﺼﺔ ﻗ ﯿﺎ دة ﺳﺎ رﻳﺔ ﻋ ﻨﺪ ﻗ ﯿﺎ دة اﻟﻤﺮﻛ ﺒﺔ اﻟﻤﺆﻣ ﻨﺔ وﺗﻘﺮﻳﺮ اﻟﻤﺮو ر و و رﻗﺔ اﻹ ﺻﻼح إﻟﺰاﻣ ﯿﺔ ﻟﻘ ﺒﻮل‬
and repair perm ission is essential for any claim s to settle. .‫ا ﻟﻤ ﻄ ﺎ ﻟ ﺒ ﺔ‬
This Certificate is a part of the Unified Com pulsory Motor Insurance Policy .‫ﺗﻌ ﺘ ﺒﺮ ﺷ ﮫﺎ دة اﻟ ﺘﺄﻣ ﯿ ﻦ ھﺬه ﺟﺰء ﻻ ﻳ ﺘﺠﺰأ ﻣ ﻦ اﻟﻮﺛ ﯿﻘﺔ اﻟﻤﻮ ﺣﺪة ﻟ ﻠ ﺘﺄﻣ ﯿ ﻦ اﻹﻟﺰاﻣﻲ ﻋ ﻠﻰ اﻟﻤﺮﻛ ﺒﺎت‬
In the event of discrepancy between the two contex t, the Arabic tex t .‫ﻋ ﻨﺪ ا ﺧ ﺘﻼ ف اﻟ ﻨ ﺺ ﺑ ﯿ ﻦ اﻟ ﻠﻐ ﺘ ﯿ ﻦ ﻳﻌ ﺘﻤﺪ اﻟ ﻨ ﺺ ﺑﺎﻟ ﻠﻐﺔ اﻟﻌﺮﺑ ﯿﺔ‬
prevails the English.
You May visit Salam a Insurance Co. web site to view the Com plete Policy ‫ﻳﻤﻜ ﻨﻚ زﻳﺎ رة اﻟﻤﻮﻗﻊ اﻹﻟﻜ ﺘﺮوﻧﻲ ﻟ ﺸﺮﻛﺔ ﺳﻼﻣﺔ ﻟ ﻠ ﺘﺄﻣ ﯿ ﻦ اﻟ ﺘﻌﺎوﻧﻲ ﻟﻺطﻼع ﻋ ﻠﻰ اﻟ ﺼ ﯿﺎﻏﺔ اﻟﻜﺎﻣ ﻠﺔ ﻟ ﻠﻮﺛ ﯿﻘﺔ‬
wording ‫اﻟ ﺘﺄﻣ ﯿ ﻦ‬

‫ﺧ ﺘ ﻢ ا ﻟ ﺸ ﺮ ﻛﺔ‬