QSN/SGM-MV/II/2026:149
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : IR. AMON FERNANDES QQ PT GLOBAL INFOTECH S
as owner and / or its associated and / or its subsidiary and / or inter related companies
for their respective rights and interests
Area : 2 Jakarta, Jawa Barat dan Banten
Period : 14 Maret 2026 to 14 Maret 2027
Territorial limit : For Business and Private used
License plate : B 1997 PFM
Year : 2022
Brand/Model : TOYOTA A250RAGBVVJ10TSCVT (RAIZE)
Sum Insured : Rp 220.000.000,-
Coverage : Comprehensive , Flood, Riot, Strike, Civil Commotion
Third party liability cover max IDR 50.000.000 in Any One Accident
Premium :
Comprehensive 2.08% =
Rp. 4.576.000
Flood (Banjir) 0.1% =
Rp. 220.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 110.000
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 375.000
=
Rp. 5.281.000
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 5.343.000


Deductible :

Comprehensive Rp. 300.000 in any one accident
RSMDCC, TSFWD, Earthquake and TS are 10% of claim or min Rp. 500.000 in any one accident
CTL and Stolen are 5% of sum insured

 
Security : Avrist


Disetujui Oleh, Jakarta, 18 April 2026





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