THE PACIFIC INSURANCE BERHAD(91603-K)

40-01, Q-Sentral, 2A Jalan Stesen Sentral 2,

Kuala Lumpur Sentral, 50470 Kuala Lumpur.
P.O. Box 12490, 50780 Kuala Lumpur
Tel : 03 - 2633 8999 Fax : 03 - 2633 8998
Website: www.pacificinsurance.com.my

Certificate of Insurance / Sijil Insurans

ROAD TRANSPORT ACT 1987 (MALAYSIA) MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) ACT (CAP 189)
(REPUBLIC OF SINGAPORE) MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) RULES (REPUBLIC OF
SINGAPORE) MOTOR VEHICLES INSURANCE (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM

Certificate Number : CVP-V3310412-K5 MX1

Nombor Sijil

1. Index mark and Registration Number of Vehicle : WCF8484

Tanda Indeks dan Nombor Pendaftaran Kenderaan

2. Name of Policyholder : MUHAMMAD NUR BIN AHMAD

Nama Pemegang Polisi

3. Effective date of the Commencement of : 05/12/2017

Insurance for the purpose of the Ordinance
Tarikh Kuatkuasa Bermula Insurans Menurut
Ordinan

4. Date of Expiry of Insurance : 04/12/2018

Tarikh Luput Insurans

5. Persons or Classes of Persons Entitled to Drive*

Orang atau Kelas Orang yang Layak Memandu*

a)The Policyholder.
b)Any other person who is driving on the Policyholder's order or with his permission.

Provided that the person driving is permitted in accordance with the licensing or other laws or regulations to drive the Motor
Vehicle or has been so permitted and is not disqualified by order of a Court of Law or by reason of any enactment or
regulations in that behalf from driving the Motor Vehicle.

a)Pemegang Polisi.
b)Sesiapa yang memandu atas arahan Pemegang Polisi atau dengan kebenarannya.

Dengan syarat orang tersebut dibenarkan memandu menurut undang-undang perlesenan atau undang-undang lain atau
peraturan untuk memandu Kenderaan Bermotor tersebut atau telah dibenarkan dan tidak dilucutkan kelayakannya diatas
perintah Mahkamah atau oleh sebab mana-mana enakmen atau peraturan daripada memandu Kenderaan Bermotor tersebut.

6. Limitation to use*
Had Penggunaan*

Use only for social, domestic and pleasure purposes and for the Policyholder's business.
The policy does not cover use for hire or reward, racing, pacemaking, reliability trial, speed-testing, the carriage of goods other
than samples in connection with any trade or business or use for any purpose in connection with the Motor Trade.

Digunakan hanya untuk tujuan sosial, domestik dan persiaran dan untuk perniagaan Pemegang Polisi.
Polisi ini tidak melindungi kegunaan untuk sewaan atau ganjaran, perlumbaan, mengkadar kelajuan, ujian kebolehpercayaan,
ujian kelajuan, membawa barangan selain daripada sampel yang berkaitan dengan apa-apa pekerjaan atau perniagaan atau
sebarang tujuan yang berkaitan dengan Motor Perdagangan.

I/We hereby certify that this covering note is issued in accordance with the provision of Part IV of the Road Transport Act 1987
(Malaysia), the Motor Vehicles (Third Party Risks & Compensation) Act (Cap 189) Republic of Singapore and the Motor Vehicles
Insurance (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam.

Saya/Kami mengesahkan bahawa nota lindungan ini dikeluarkan mengikut Akta Pengangkutan Jalan 1987 (Malaysia), Peruntukan
Bahagian IV, Kenderaan Bermotor (Third Party Risks & Compensation) Act (Cap 189) Republik Singapura dan Insurans Kenderaan
Bermotor (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam.

* Limitation rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third
Party Risks and Compensation) Act (Cap 189) Republic of Singapore of Section 7 of the Motor Vehicles Insurance (Third Party
Risks) Act (Cap 90) Negara Brunei Darussalam are not included under this heading.
Pengehadan dijadikan tidak berkuat kuasa oleh Seksyen 95 Akta Pengangkutan Jalan 1987 (Malaysia) atau Section 8 of the Motor
Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore or Section 7 of the Motor Vehicles Insurance
(Third Party Risks) Act (Cap 90) Negara Brunei Darussalam tidak termasuk dibawah tajuk ini.

THIS IS A COMPUTER GENERATED DOCUMENT AND NO SIGNATURE IS REQUIRED.

Ini adalah dokumen yang dikeluarkan oleh komputer dan tidak memerlukan tandatangan.