Reliance Private Car Vehicle Certificate cum Policy Schedule

Policy / Certificate No. : 1305732311006824

Proposal /Covernote No : 114000082963 Business/Occupation: None
Name of Insured : MR JITENDER PANWAR Period of Insurance : From 00:01 Hrs on 23/03/2014 to 22/03/2015 on 23:59
Address :
WZ-37 CHOUKHANDI VILL TILAK NAGAR ASHOK NAGAR NEW
DELHI TILAK NAGAR EAST WEST DELHI 110018 DELHI
Contact details : 9822611890 Hypothecated with Icici Bank Ltd
Email ID : Zone A Geographical Area India
Particulars of vehicle Insured :
Own Damage
Basic OD 7,261.00
Total Basic Own Damage Premium 7,261.00
Deduct 25% for NCB -1,815.22
TOTAL OWN DAMAGE PREMIUM 5,445.67
Liability
Basic Liability 941.00
Total Basic Liability Premium 941.00
PA Benefits
Compulsory PA cover to Owner Driver of CSI 200000(IMT-15) 100.00
PA to unnamed passenger (Endt. IMT -16)Passengers: 5 CSI per person: 80000 200.00
Total PA Premium 300.00
Legal Liability
LLP to paid driver,cleaner & conductor (Endt. IMT- 28) No. of people: 1 50.00
Total Legal Liability Premium 50.00
Total Liability Premium 1,291.00
Package Premium 6,736.67
Add:Service Tax (12% of Net Premium) 808.40
Add:Education Cess (2% of Service Tax) 16.17
Add:Secondary & Higher Education Cess(1% of Service Tax) 8.08
FINAL PREMIUM 7,569.00
Subject to I.M.T. Endt.Nos. & Memorandum printed/herein/attached hereto. IMT22,15,28,16,7 Service Tax Reg.No. AABCR6747BST001
Category-General Insurance Business Service 00440005
Subject to Reliance GI Endorsement Numbers printed herein/attached hereto. NA
** "No Claim Bonus is subject to no claim on the previous policy. Benefits under the policy stands forfeited if claim is/was made in previous policy".
Premium Schedule
Registration Number and
Place
Make / Model Engine / Chassis No.Vehicle Type of body Cubic Capacity Year of MFG Seating Capacity
of side car (if any)
including driver
Net Premium Rs. IDV (Insured's Declared
Value) Rs
DL10CB4220
Delhi Rajouri Garden
CHEVROLET
BEAT DIESEL 1.0 LT
20330142
006203
936 2012 5 6,736.67 387,000.00
Limitations As To Use
The Policy covers use for any purpose other than: a. Hire or Reward, b. Carriage of goods (other than samples or personal luggage), c. Organized racing, d. Pace making, e. Speed testing, f. Reliability trials, g. Any
purpose in connection with Motor Trade
Persons/Classes of Persons entitled to drive :
Any person including the Insured provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the
person holding an effective Learner's License may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limits of Liability :
a. Under Section II-1(i) of the Policy-Death of or bodily injury to any person so far as it is necessary to meet the requirements of the Motor Vehicle Act, 1988. b. Under Section II (1)(ii) of the Policy-Damage to
property other than property belonging to the insured or held in trust or in the custody of control of the insured up to the limits specified Rs.7.5 lakhs .
Deductible under Section-
(i)Compulsory deductible Rs. 1000/-(ii) Additional compulsory deductible Rs. 0/-(iii) Voluntary deductible Rs. 0 /-(iv) PA Cover for owner-driver under section III CSI Rs. 200000/-
Special Conditions: NA
It is hereby declared and agreed that all pre-existing damages to the vehicle having occurred prior to the commencement of cover are excluded from the scope of the policy.
The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.co.in
Consolidated stamp duty paid vides Receipt No. MH001089159201314E dated 31/12/2013 Not applicable for the State of Jammu and Kashmir.
I/We hereby certify that the Policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the provision of Chapter X and Chapter XI of M.V. Act, 1988. Note: In the event
of dishonor of cheque, this policy document automatically stands cancelled from inception irrespective of whether a separate communication is sent or not. No Claim Bonus will only be allowed, provided the policy is
renewed within 90 days of the expiry of the previous policy.
Insured's Declared Value
For the Vehicle (Rs) For Trailers (Rs) Non Elec.
Accessories (Rs)
Elec./Electronic
Accessories (Rs)
Value of CNG/LPG
Kit (Rs)
Total IDV (Rs)
387,000.00 0.00 0.00 0.00 0.00 387,000.00
The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject otherwise the terms, conditions and exclusions of the Reliance
Private Car Package Policy. In Witness whereof this Policy has been signed at Mumbai on 21/03/2014 in lieu of Cover Note No. 114000082963 dated 18/03/2014
In the unfortunate event of a claim, Please call along with your Policy No. on 1800 3009 (toll free) and register your claim immediately within 7 days from the date of loss. For Customer
service, Please call along with your Policy No. on 1800 3009|www.reliancegeneral.co.in
IMPORTANT NOTICE : The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule.
Any payment made by the Company by reason of wider terms appealing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is For Reliance General Insurance Co. Ltd.
recoverable from the Insured.See the clause headed 'AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY'. For legal
interpretation,English version will hold good.NOTE: Kindly acknowledge receipt of this policy. In case you find any variations against your
proposal or anydiscrepancy in the policy,kindly contact us immediately
Reliance General Insurance Co. Ltd. Duly Constituted Attorney(s)
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg, Ballard Estate, Mumbai - 400 001
Policy Issuing Office : 570, Naigaum Cross Road, Next to Royal Industrial Estate, Wadala (W), Mumbai - 400 031
Policy servicing office : Plot no. 60, Okhla Industrial Estate,,Phase-3, Opp. SBI Bank,New Dellhi-110020, Delhi,NEW DELHI,DELH - 110019
Intermediary Code/Name :
11BRG051 / RELIANCE COMPOSITE INSURANCE BROKINGLTD
Intermediary Contact No:
2230522444 / 9866681582
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai - 400 001
General Insurance
To, Date: 21/03/2014
Reliance General Insurance Company Ltd.
Nehru Place
K.G. ROAD,NAWADA,ARRAH 802301
06182-284
Dear Sir,
Sub: Confirmation of No Claim Bonus(NCB)Declaration
Insured Name MR JITENDER PANWAR NCB% applied on the policy 25%
Vehicle Insured CHEVROLET
BEAT DIESEL 1.0 LT
Vehicle Registration Number DL10CB4220
Type of Cover Package Only policy Your Policy No./Cover Note no. 1305532311003488
Policy Start Date 23/03/2013 Policy End Date 22/03/2014
The proposer has declared that the request was submitted to you for issuance of a NCB Certificate. However, as the proposer is unable to furnish the same issued from
your office as proof of NCB Entitlement that may be availed as per provisions of the India Motor Tariff we have accepted the proposal and permitted the claimed NCB as per
declaration submitted to us by the proposer|
Accordingly, we would request you to:
Confirm that the information mentioned above is correct: Yes/No
If No,please state nature of incorrect information and the actual position thereof:-
State whether any claim under your Policy has been reported(OD/Liability Claim): Yes/No
If Yes,date & amount of claim lodged:
This letter is being sent as per GR 27 of India Motor Tariff.We request you to kindly provide us with the desired information by filling up the same in the original & sending it
to us.
An early response will be highly appreciated. Please not you are required to respond to this lettler within 30 days of receipt of this letter. In case we do not receive a
response from you within this time frame,it shall be deemed that you have confirmed that the information provided by the Proposer(as contained herein) is true and correct.
Yours faithfully,
For Reliance General Insurance Company Limited,
To,
The Manager,
Reliance General Insurance Co.Ltd.
Reference:Our Policy No 1305732311006824
Plot no. 60, Okhla Industrial Estate,
Phase-3, Opp. SBI Bank,New Dellhi-110020
Delhi,NEW DELHI
DELH
110019
We Confirm that the insured is eligible/Not Eligible(Strike Out) for 25% NCB
Authorised Signatory
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai - 400 001
General Insurance