Certificate - PDF - PDF by zhangyun


									                                                                                      AXA Insurance UK plc
                                                                                                                    Agency Number                     4672276

                                                                                              This Certificate of Motor Insurance takes the place of an International Motor Insurance Card (Green Card)
                                                                                              and is evidence that the insurance extends to include the compulsory Motor Insurance requirements of
                                                                                                     a) Any member country of the European Union
                                                                                                     b) Croatia, Gibraltar, Iceland, Liechtenstein, Monaco, Norway, San Marino and Switzerland
                                                                                              Cette attestation d'assurance automobile remplace la carte d'assurance automobile internationale (“ carte
                                                                                              Verte”) et est la preuve que l'assurance couvre également les exigences d'assurance automobile obligatoires
                                                                                                     a) De n'importe quel pays membre de l’Union européenne
 Mr Mark Kopczewski                                                                                  b) De la Croatie, Gibraltar, d'Islande, le Liechtenstein, Monaco, la Norvège, San Marino et la Suisse
                                                                                              El certificado del seguro de automóviles que le fue presentado reemplaza a la Tarjeta Internacional del
 134 Salisbury Road                                                                           seguro de automóviles (la “ Tarjeta Verde”) y demuestra que en dicho seguro están incluidos los requisitos
                                                                                              obligatorios del seguro de automóviles de
                                                                                                     a) Cualquier país miembro del la Unión Europea
 CHRISTCHURCH                                                                                        b) Croacia, Gibraltar, Islandia, Liechtenstein, Monaco, Noruega, San Marino, Suiza
                                                                                              Si su vehiculo es embargado tras un accidente, debe presentarse el siguiente texto a las autoridades
                                                                                              Die Ihnen ausgehändigte KFZ-Versicherungsbestätigung tritt an die Stelle des internationalen
                                                                                              Versicherungsscheins (der grünen Karte) und bildet den Nachweis dafür, daß sich der Versicherungsschutz
 BH23 7JP                                                                                     ebenfalls auf die gesetzlich vorgeschriebenen Versicherungserfordernisse der folgenden Länder erstreckt
                                                                                                    a) Sämtliche Mitgliedsstaaten der Europäischen Union
                                                                                                    b) Kroatien, Gibraltar, Island, Liechtenstein, Monaco, Norwegen, San Marino und der Schweiz

                               CERTIFICATE OF MOTOR INSURANCE
                                                                                                                       Certificate Number                      4672276M024822
           1. Registration Mark of Vehicle.                                                                                                                                                 W 60
           2. Description of Vehicle.
             FORD MONDEO LX TDCI (115) Estate Car/Stat
             Any motor car supplied to the Policyholder under an agreement between the
             Insurer and an agreed approved repairer or hire company as a direct result
             of :- a) damage covered by this policy, or b) unrecovered theft.
           3. Name of Policyholder.
             Mr Mark Kopczewski
           4. Effective date of commencement of insurance
              for the purposes of the relevant law.
             1204 hours 28th February 2011
           5. Date of expiry of insurance.
             2359 hours 2nd September 2011
           6. Persons or classes of persons entitled to drive.
             Those specified below, provided that the person driving holds a licence to drive the
             vehicle or has held and is not disqualified for holding or obtaining such a licence.
             Insured And Named Drivers
             Mr Zbigniew Tomasz Kopp

             The policyholder may also drive (with the owner's consent) any motor car not belonging
             to him (her) and not hired to him (her) under a hire purchase agreement.

           7. Limitations as to use subject to the exclusions below.
             Social, Domestic & Pleasure

             Social, domestic and pleasure use only. EXCLUDING use for hiring, racing, pacemaking, speed testing, competitions
             rallies, trials, commercial travelling, or use for any purpose in connection with the Motor Trade.

            Further Excluding:
            'Use to secure the release of a motor car, other than the vehicle identified above by its registration mark, which
            has been seized by, or on behalf of, any government or public authority'
I hereby certify that the Policy to which this certificate relates satisfies the AXA Insurance UK plc
requirements of the relevant Law applicable in Great Britain, Northern            Authorised Insurers
Ireland, the Isle of Man, the Island of Guernsey, the Island of Jersey and Address:              5 Old Broad Street London

the Island of Alderney.                                                                          EC2N 1AD
                                                                                                 Registered in England No: 78950
                                                                                                 Authorised and regulated by the Financial Services Authority, Registration No. 202312

  AUTHENTICATED                                                                  Philippe Maso y Guell Rivet
  as authorised agent on behalf of the Insurer                                   Chief Executive
                                                                                 AXA Insurance UK plc
 NOTE: For full details of the insurance cover reference should be made to the Policy.
 ADVICE TO THIRD PARTIES. Nothing contained in this certificate affects your right as a Third Party to make a claim.
 Warning: This certificate has been prepared using a laser printer and is not valid if altered in any way.
          For change of vehicle or termination of insurance - Refer to your policy booklet.

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