Unified Compulsory Motor Insurance Policy Schedule ﺟ ﺪ و ل اﻟ ﻮﺛﻴ ﻘ ﺔ اﻟ ﻤ ﻮ ﺣ ﺪ ة ﻟﻠﺘﺄ ﻣﻴ ﻦ ا ﻹﻟ ﺰا ﻣ ﻲ ﻋﻠ ﻰ اﻟ ﻤ ﺮ ﻛﺒﺎ ت
Insurance details ﺑﻴﺎﻧﺎ ت اﻟﺘ ﻐ ﻄﻴ ﺔ اﻟﺘﺄ ﻣﻴﻨﻴ ﺔ
Product ID : A-SALM-1-B-08-009 : رﻗ ﻢ اﻟ ﻤﻨﺘ ﺞ
Branch : Tameeni : اﻟﻔ ﺮع
Policy Number : 94/1/199348/2023 : رﻗ ﻢ اﻟ ﻮﺛﻴﻘ ﺔ
Issue Date and Time : 23/09/2023 04:21:19 : ﺗ ﺎ ر ﻳ ﺦ و و ﻗ ﺖ ا ﻹ ﺻ ﺪا ر
From To
Date\time cover start and End : : و ﻗ ﺖ ﺑ ﺪا ﻳ ﺔ و ﻧ ﻬ ﺎ ﻳ ﺔ ا ﻟ ﺘ ﻐ ﻄ ﻴ ﺔ ا ﻟ ﺘ ﺄ ﻣ ﻴ ﻨ ﻴ ﺔ/ﺗ ﺎ ر ﻳ ﺦ
29/09/2023 28/09/2024
Insured Details ﺑﻴﺎﻧﺎ ت اﻟ ﻤ ﺆ ﻣ ﻦ ﻟ ﻪ
Insured Name : ﻋ ﺜ ﻤ ﺎ ن ﺳ ﻴ ﺪ ﻣ ﺤ ﻤ ﺪ ﻓ ﺮا ج : ا ﺳ ﻢ اﻟﻌ ﻤﻴ ﻞ
Date of Birth / Age : 01-01-1994 /30 : اﻟﻌ ﻤ ﺮ/ ﺗﺎ رﻳ ﺦ اﻟ ﻤﻴ ﻼ د
Saudi ID / Iqama Number : 2140831823 : ا ﻹﻗﺎ ﻣ ﺔ/ رﻗ ﻢ ﻫ ﻮﻳ ﺔ اﻟ ﻮ ﻃﻨﻴ ﺔ
Address : 3625 - 6772-42351 اﻟﻤﺪﻳﻨﺔ اﻟﻤﻨﻮرة- ﺣﻲ اﻟﺠﺎﻣﻌﺔ- رﻓﻴﺪه اﻻﻧﺼﺎرﻳﻪ : ا ﻟ ﻌ ﻨ ﻮا ن
Home / Work / Tele No. / Mobile No. : 0563294093 : ر ﻗ ﻢ ا ﻟ ﺠ ﻮا ل/ ا ﻟ ﻌ ﻤ ﻞ/ ﻫ ﺎ ﺗ ﻒ ا ﻟ ﻤ ﻨ ﺰ ل
Insured Vehicle Details ﺑﻴﺎﻧﺎ ت اﻟ ﻤ ﺮ ﻛﺒ ﺔ اﻟ ﻤ ﺆ ﻣﻨ ﺔ
Vehicle Brand : ﻫ ﻮ ﻧ ﺪا ي : ﻣﺎ رﻛ ﺔ اﻟ ﻤ ﺮﻛﺒ ﺔ
Vehicle Model : ا ﻟ ﻨ ﺘ ﺮا : ﻃ ﺮا ز ا ﻟ ﻤ ﺮ ﻛ ﺒ ﺔ
Vehicle Color : ازر ق : ﻟ ﻮ ن اﻟ ﻤ ﺮﻛﺒ ﺔ
Vehicle Registration Expiry Date : 05/06/1443 : ﺗﺎ رﻳ ﺦ اﻧﺘ ﻬﺎء ر ﺧ ﺼ ﺔ اﻟ ﺴﻴ ﺮ
Manufacture Year : 2010 : ﺳﻨ ﺔ اﻟ ﺼﻨﻊ
Vehicle Body Type : ﺑﺎ ب4 ﺳﻴﺎ ر ة ﺻﻐﻴ ﺮ ة : ﻧ ﻮع ﻫﻴ ﻜ ﻞ اﻟ ﻤ ﺮﻛﺒ ﺔ
Type of Use : ﺷﺨ ﺼﻲ : ﻏ ﺮ ض ا ﻹ ﺳ ﺘ ﺨ ﺪا م
Type of Registration : Private Car : ﻧ ﻮع ﺗ ﺴ ﺠﻴ ﻞ اﻟ ﻤ ﺮﻛﺒ ﺔ
Chassis Number : KMHDT41B6AU950773 : رﻗ ﻢ اﻟ ﻬﻴ ﻜ ﻞ
Plate No. : 9709 ب ح ا : ر ﻗ ﻢ ا ﻟﻠ ﻮ ﺣ ﺔ
Sequence No. / Custom Card No. : 82179900 : ر ﻗ ﻢ ا ﻟ ﺒ ﻄ ﺎ ﻗ ﺔ ا ﻟ ﺠ ﻤ ﺮ ﻛ ﻴ ﺔ/ ا ﻟ ﺮ ﻗ ﻢ ا ﻟ ﺘ ﺴﻠ ﺴﻠ ﻲ
Premium Details ﺑﻴﺎﻧﺎ ت ﻗ ﺴ ﻂ اﻟﺘﺄ ﻣﻴ ﻦ
Gross Premium : 1126.59 : اﻟﻘ ﺴ ﻂ ا ﻷ ﺳﺎ ﺳ ﻲ
No Claim Discount : : ﻗﻴ ﻤ ﺔ ﺧ ﺼ ﻢ ﻋﺪ م و ﺟ ﻮ د ﻣ ﻄﺎﻟﺒﺎ ت
Commission : 22.98 : اﻟﻌ ﻤ ﻮﻟ ﺔ
Vaule added Tax : 172.37 : ﺿ ﺮﻳﺒ ﺔ اﻟﻘﻴ ﻤ ﺔ اﻟ ﻤ ﻀﺎﻓ ﺔ
Final Prmeium : 1321.49 : اﻟﻘ ﺴ ﻂ اﻟﻨ ﻬﺎﺋ ﻲ
Conditions اﻟ ﺸ ﺮ و ط
Exclude the cover if the vehicle is driven by a person under the age of 18 (according to the ﻣﺎ ﻣﻴ ﻼ دﻳﺎ ً ﻣﺎ ﻟ ﻢ ﻳ ﻜ ﻦ ﻫ ﻮ اﻟ ﻤ ﺆ ﻣ ﻦ ﻟ ﻪ و ﻣﺎ ﻟ ﻢ ﻳ ﺮ د ا ﺳ ﻤ ﻪ ﻣ ﻦ
ً ( ﻋﺎ18) ﻳﺴﺘﺜﻨﻰ ﻗﻴﺎدة أي ﺷﺨﺺ ﻳﻘﻞ ﻋﻤﺮه ﻋﻦ
Gregorian calendar) unless the said person is the insured or is included among the names of .( ﺳﻨﺔ ﻓﻲ ﺟﺪول اﻟﻮﺛﻴﻘﺔ18) أﺳﻤﺎء اﻟﺴﺎﺋﻘﻴﻦ اﻟﻤﺴﻤﻴﻦ اﻟﺬﻳﻦ ﺗﻘﻞ أﻋﻤﺎرﻫﻢ ﻋﻦ
authorized drivers under the age of 18 in the Policy schedule.
The Cover start after 24 Hours from Issuance Date and Time and no claim will be entertained ﺳﺎﻋﺔ ﻣﻦ ﺗﺎرﻳﺦ و وﻗﺖ إﺻﺪار اﻟﺘﺄﻣﻴﻦ وﻟﻦ ﻳﺘﻢ ﻗﺒﻮل أي ﻣﻄﺎﻟﺒﺔ ﻗﺒﻞ ﺗﺎرﻳﺦ و وﻗﺖ24 ﺗﺴﺮي اﻟﺘﻐﻄﻴﺔ ﺑﻌﺪ
before the inception. .اﻟ ﺴ ﺮﻳﺎ ن
In Case the city of accident is different from Client national address city the company has the ﻓ ﻲ ﺣ ﺎ ل إ ﺧ ﺘ ﻠ ﻔ ﺖ ﻣ ﺪ ﻳ ﻨ ﺔ ا ﻟ ﺤ ﺎ د ث ﻋ ﻦ ﻣ ﺪ ﻳ ﻨ ﺔ ا ﻟ ﻤ ﺬ ﻛ ﻮ ر ة ﻓ ﻲ ا ﻟ ﻌ ﻨ ﻮا ن ا ﻟ ﻮ ﻃ ﻨ ﻲ ﻟ ﻠ ﻌ ﻤ ﻴ ﻞ ﻳ ﺤ ﻖ ﻟ ﺸ ﺮ ﻛ ﺔ ﻃ ﻠ ﺐ إ ﺛ ﺒ ﺎ ت
right to ask for prove of residence at claim processing time . ا ﻟ ﻌ ﻨ ﻮا ن ا ﻟ ﻮ ﻃ ﻨ ﻲ ﻟ ﻠ ﻌ ﻤ ﻴ ﻞ ﻋ ﻨ ﺪ إ ﺟ ﺮا ءا ت ا ﻟ ﻤ ﻄ ﺎ ﻟ ﺒ ﺔ
No refund for deletion of vehicle on which claim has been reported. .ﻻ ﻳ ﺘ ﻢ إ ر ﺟ ﺎ ع أ ي ﻣ ﺒ ﺎ ﻟ ﻎ ﻣ ﺎ ﻟ ﻴ ﺔ ﻓ ﻲ ﺣ ﺎ ل ﺗ ﻘ ﺪﻳ ﻢ ﻃﻠ ﺐ إ ﻟ ﻐ ﺎ ء ﻟ ﻤ ﺮ ﻛ ﺒ ﺔ ﺗ ﻮ ﺟ ﺪ ﻋﻠ ﻴ ﻬ ﺎ ﻣ ﻄ ﺎ ﻟ ﺒ ﺎ ت
All Vehicles used in general transportation or Rent A Car or Limousines are excluded from the أو اﻟﻤﺮﻛﺒﺎت/أو ﻣﺮﻛﺒﺎت أﺟﺮة و/أو اﻹﻳﺠﺎر اﻟﻴﻮﻣﻲ و/ﺟﻤﻴﻊ اﻟﻤﺮﻛﺒﺎت اﻟﻤﺴﺘﺨﺪﻣﺔ أو ﻣﺴﺠﻠﺔ ﻓﻲ اﻟﻨﻘﻞ اﻟﻌﺎم و
cover and no claim will be entertained related to this type of vehicles ﻣ ﺴ ﺘ ﺜ ﻨ ﺎ ة ﻣ ﻦ ا ﻟ ﺘ ﻐ ﻄ ﻴ ﺔ و ﻟ ﻦ ﻳ ﺘ ﻢ ﻗ ﺒ ﻮ ل أ ي ﻣ ﻄ ﺎ ﻟ ﺒ ﺔ ﻣ ﺘ ﺼ ﻠ ﺔ ﻣ ﻊ ا ﻷ ﻧ ﻮا ع ا ﻟ ﻨ ﻘ ﻞ ا ﻟ ﻤ ﺬ ﻛ ﻮ ر ة أ ﻋ ﻼ ه
Admin fees of SR. 34.50/- including VAT will be deducted from refund premium at policy . رﻳﺎل ﺷﺎﻣﻞ ﺿﺮﻳﺒﺔ اﻟﻘﻴﻤﺔ اﻟﻤﻀﺎﻓﺔ ﻋﻨﺪ إﻟﻐﺎء اﻟﻮﺛﻴﻘﺔ34.5 ﻳﺘﻢ ﺧﺼﻢ رﺳﻮم إدارﻳﺔ ﺑﻘﻴﻤﺔ ﻣﺒﻠﻎ
cancelation time
This Certificate deemed Null and void in case of written off /Modified/Change. . ﺗ ﻐ ﻴ ﻴ ﺮ ﺑ ﻴ ﺎ ﻧ ﺎ ﺗ ﻬ ﺎ/ ﺗ ﻌ ﺪ ﻳ ﻠ ﻬ ﺎ/ﺗ ﻌ ﺘ ﺒ ﺮ ﻫ ﺬ ه ا ﻟ ﺸ ﻬ ﺎ د ة ﻻ ﻏ ﻴ ﺔ ﻓ ﻲ ﺣ ﺎ ل ﺗ ﻢ ﺷ ﻄ ﺒ ﻬ ﺎ
Valid Driving License at time of driving the insured vehicle and Police report and repair و ﺟ ﻮ د ر ﺧ ﺼ ﺔ ﻗ ﻴ ﺎ د ة ﺳ ﺎ ر ﻳ ﺔ ﻋ ﻨ ﺪ ﻗ ﻴ ﺎ د ة ا ﻟ ﻤ ﺮ ﻛ ﺒ ﺔ ا ﻟ ﻤ ﺆ ﻣ ﻨ ﺔ و ﺗ ﻘ ﺮ ﻳ ﺮ ا ﻟ ﻤ ﺮ و ر و و ر ﻗ ﺔ ا ﻹ ﺻ ﻼ ح إ ﻟ ﺰا ﻣ ﻴ ﺔ ﻟ ﻘ ﺒ ﻮ ل
permission is essential for any claims to settle. .اﻟ ﻤ ﻄﺎﻟﺒ ﺔ
This Certificate is a part of the Unified Compulsory Motor Insurance Policy . ﺗ ﻌ ﺘ ﺒ ﺮ ﺷ ﻬ ﺎ د ة ا ﻟ ﺘ ﺄ ﻣ ﻴ ﻦ ﻫ ﺬ ه ﺟ ﺰ ء ﻻ ﻳ ﺘ ﺠ ﺰأ ﻣ ﻦ ا ﻟ ﻮ ﺛ ﻴ ﻘ ﺔ ا ﻟ ﻤ ﻮ ﺣ ﺪ ة ﻟ ﻠ ﺘ ﺄ ﻣ ﻴ ﻦ ا ﻹ ﻟ ﺰا ﻣ ﻲ ﻋ ﻠ ﻰ ا ﻟ ﻤ ﺮ ﻛ ﺒ ﺎ ت
In the event of discrepancy between the two context, the Arabic text prevails the English. .ﻋ ﻨ ﺪ ا ﺧ ﺘ ﻼ ف ا ﻟ ﻨ ﺺ ﺑ ﻴ ﻦ ا ﻟﻠ ﻐ ﺘ ﻴ ﻦ ﻳ ﻌ ﺘ ﻤ ﺪ ا ﻟ ﻨ ﺺ ﺑ ﺎ ﻟﻠ ﻐ ﺔ ا ﻟ ﻌ ﺮﺑ ﻴ ﺔ
You May visit Salama Insurance Co. web site to view the Complete Policy wording ﻳ ﻤ ﻜ ﻨ ﻚ زﻳ ﺎ ر ة ا ﻟ ﻤ ﻮ ﻗ ﻊ ا ﻹ ﻟ ﻜ ﺘ ﺮ وﻧ ﻲ ﻟ ﺸ ﺮ ﻛ ﺔ ﺳ ﻼ ﻣ ﺔ ﻟﻠ ﺘ ﺄ ﻣ ﻴ ﻦ ا ﻟ ﺘ ﻌ ﺎ وﻧ ﻲ ﻟ ﻺ ﻃ ﻼ ع ﻋﻠ ﻰ ا ﻟ ﺼ ﻴ ﺎ ﻏ ﺔ ا ﻟ ﻜ ﺎ ﻣﻠ ﺔ ﻟﻠ ﻮﺛ ﻴ ﻘ ﺔ
اﻟﺘﺄ ﻣﻴ ﻦ
ﺧﺘ ﻢ اﻟ ﺸ ﺮ ﻛ ﺔ
