NON-LAND TRANSPORTATION OPERATOR'S VEHICLE Client's Copy
CONFIRMATION OF COVER NO. 091000003283009
AUTHENTICATION NO.: 091JUZQC2402 POLICY NO.
BS-PMM-201698696
NAME AND ADDRESS OF INSURED BUSINESS DATE ISSUED
CHRISTIAN RIGODON DIAMANTE New Business 12/20/2024
AGENT'S CODE 20000754 PAID UNDER O.R. NO.
ZONE V UPPER CAMAYA PERIOD OF INSURANCE
MARIVELES BATAAN
Bataan FROM 12/20/2024 TO 12/20/2027
SCHEDULED VEHICLE
MAKE/MODEL/BODY TYPE SERIAL/CHASSIS NO.
2024 HONDA CLICK 125 I S.E MOTORCYCLE K2VL1153137
PLATE NO. COLOR MOTOR NO. MV FILE NO.
NONE GRAY/BLACK JA69E7864931 NEW
SECTION I/II THIRD PARTY LIABILITY LIMIT OF LIABILITY 200,000 PER ACCIDENT
(Subject to the Schedule Of Indemnities shown in the Master Policy) PREMIUMS
This Confirmation of Cover is evidence of the policy of insurance required under
insurance required under chapter VI - Compulsory Motor Vehicle Liability Insurance PREMIUM 576.00
RMA 230 of the Insurance Code amended by Presidential Decree No. 1814 PREMIUM TAX 69.12
DST 72.00
LGT 2.88
TOTAL 720.00
RMA 230
Patricia E. Chilip Eileen L. Tulio AUTHENTICATION FEE 50.40
Rev. 3-3 President Branch Head
03/18/2024
TOTAL AMOUNT DUE 770.40
NON-LAND TRANSPORTATION OPERATOR'S VEHICLE LTO Copy
CONFIRMATION OF COVER NO. 091000003283009
AUTHENTICATION NO.: 091JUZQC2402 POLICY NO.
BS-PMM-201698696
NAME AND ADDRESS OF INSURED BUSINESS DATE ISSUED
CHRISTIAN RIGODON DIAMANTE New Business 12/20/2024
AGENT'S CODE 20000754 PAID UNDER O.R. NO.
ZONE V UPPER CAMAYA PERIOD OF INSURANCE
MARIVELES BATAAN
Bataan FROM 12/20/2024 TO 12/20/2027
SCHEDULED VEHICLE
MAKE/MODEL/BODY TYPE SERIAL/CHASSIS NO.
2024 HONDA CLICK 125 I S.E MOTORCYCLE K2VL1153137
PLATE NO. COLOR MOTOR NO. MV FILE NO.
NONE GRAY/BLACK JA69E7864931 NEW
SECTION I/II THIRD PARTY LIABILITY LIMIT OF LIABILITY 200,000 PER ACCIDENT
(Subject to the Schedule Of Indemnities shown in the Master Policy) PREMIUMS
This Confirmation of Cover is evidence of the policy of insurance required under
insurance required under chapter VI - Compulsory Motor Vehicle Liability Insurance PREMIUM 576.00
of the Insurance Code amended by Presidential Decree No. 1814 PREMIUM TAX 69.12
DST 72.00
LGT 2.88
TOTAL 720.00
RMA 230
Patricia E. Chilip Eileen L. Tulio AUTHENTICATION FEE 50.40
Rev. 3-3
President Branch Head
03/18/2024
TOTAL AMOUNT DUE 770.40
