THE NEW INDIA ASSURANCE CO. LTD.

(Wholly owned by the Govt. of India)

POLICY SCHEDULE FOR HULL MACHINERY INSURANCE

Insured Name : SAN MARINE

Insured's Details Issuing Office Details
Customer ID : PO55299158 Office Code : HYDERABAD LCBO 960000 (960000)
Address : 5TH FLOOR SHARIF TOWERS, Address : LARGE CORPORATE AND
MAIN ROAD, PALLAM RAJU NAGAR, BROKERS OFFICE, 104, 2ND
KAKINADA. FLOOR, SURYA TOWERS,
KAKINADA ,ANDHRA PRADESH, S.P.ROAD, SECUNDERABAD
533001
,500003
Phone No : Phone No : 4027810300 / 4027810302 /
4027810300
E-mail/Fax : projects@sanmarine.in, E-mail/Fax : lcohydro@newindia.co.in
PAN No : ACGFS0660N S.Tax Regn. No :
GSTIN/UIN : 37ACGFS0660N1ZQ / NA GSTIN : 36AAACN4165C3ZQ
: SAC : 997139 (Other non-life insurance
services excl RI)

Policy Details
Policy Number : 96000022170100000021 Business Source Code
Period of Insurance : From:24/11/2017 12:00:01 AM To: Dev.Off. : NTRUST INSURANCE BROKING
23/11/2018 11:59:59 PM level/Broker/Corp. Agent SERVICES PVT LTD - (BR00000156)
NTRUST INSURANCE BROKING
SERVICES PVT LTD (SI00075618)
Date of Proposal : 24-Nov-17 Agent/Bancassurance :
Prev. Policy no. : Phone No : NA / NA
Client Type : Non-Corporate E-mail/Fax : accounts@ntrust.co.in, /

Premium ` GST` Total(INRin Figures) Total(INR in Words) Receipt No. & Date
441187 80641 528649 RUPEES FIVE LAC 9600008117000000748
TWENTY-EIGHT 2 - 01/12/17
THOUSAND SIX
HUNDRED FORTY-NINE
ONLY
Stamp Duty INR 6821
Installment Details
Installment Premium` GST` Total` Payable On or Before
FULL PREMIUM 441187 80641 528649 24/11/2017
Vessel Details
Name of Vessel IMO No. Sub Type of Vessel Sub Type Year of Port of Registration and
Vessel description Make Authority
VO101 M-7725 Dumb Barges Dumb Barge with 2008 IRS MUMBAI
Batching Plant.
Vessel Sum Insured` Annual Premium` Deductible`
H&M Increased Freight Total
Value
Inland Vessel 68210000 0 0 68210000 441187 350000

Special Conditions : Annexure was given for warranties

Special Warranties : NA,NA,NA,NA
Additional Peril Deductible : NA
TRADING LIMITS/TRADING WARRANTIES
East Coast

The Insurance under this policy is subject to Hull and Machinery clauses and conditions attached herewith -
Sl. No. Terms and Conditions Title

Signature Not
Verified
Digitally signed
by Srinivasan Policy No. : 96000022170100000021Document generated by 17054 at 01/12/2017 16:01:17 Hours.
Vaideswaran Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2017.12.01
For 16:01:19
redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
IST
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

Page 1 of 3
 THE NEW INDIA ASSURANCE CO. LTD.
(Wholly owned by the Govt. of India)

1 Clauses 1. CL-346 : Institute Fishing Vessel Clause

20.7.87
2. CL-294 : Additional Perils Clause
3. CL-306 : Additional Machinery Damage Clause
4. CL-356 : Institute Radioactive Contamination,
Chemical, Biological, Bio-Chemical and
Electromagnetic Exclusions Clause
5. CL-380 : Institute Cyber attack clause
6. Strike Riot and Civil Commotion Clause
7. CL-298 : Additional Machinery damage
Deductible Clause (CL.298)
8. CL-390(S) : Institute War Clauses (For foreign
flagged but Indian Managed vessels)
9. CL-362 : Leased equipments Clause
10. CL-311(S) : Ports Removed Clause
11. Bearing Sea Transit Clause
12. CL-311 : ITC Hulls Port Risk Clause dated
20.7.1987
13. Pilots non liability clause
14. Ship to Ship Lightening Clause
15. CL-280 : ITC Hulls 01.10.83
16. CL-289 : ITC Hulls Total Loss only(including
Salvage,Salvage Charges,Sue,Labour) 1.10.83
17. CL-290 : ITC Hulls Disbursement and
Increased Value(TL and Excess Liabilities) 1.10.83
18. CL-284 : Institute Hulls Total Loss,General
Average 3by4 th Collision Liability 1.10.83
19. CL-287 : Institute Time Clause Freight dated
1.8.89
20. CL-342 : General Average Disbursement
Clause A
21. CL-328 : Institute Hulls Yacht Clause
2 Conditions 1. CL-280(S) : Cancellation Returns Only
2. Condition Cum Valuation Report by IRDA A
Category Surveyor
3. Vessel shall be inspected by independent
licenced Surveyor
4. All approvals onboard the vessel during
beaching
3 Endorsements 1. Endosements PA Cover for Fishing Vessels
4 Special Conditions 1. CL-346(S) : Institute Fishing Vessel Clause
20.7.87, but limited to pay only TL or CTL
2. Subject to Ice Clause and Local navigational
rules and regulations complied with
3. CL-267(S) : Deletion of Indian Coal warranty
4. CL-346(S) : Clause20, P and I Risk of Institute
Fishing Vessels Clause dated 20.7.87 deleted
5. CL-342(S) : Special G.A Condition
6. CL-328(S) : Deletion of Clause 5 of Institute
Yacht Clause and Clause 19 applicable
7. CL-312 : ITC Hulls Port Risk including Limited
Navigation 20.7.87
8. CL-289(S) : Inst. Total Loss Only including
Salvage Charges with 4by4 Collision Liability
9. CL-289(S) : Inst. Total Loss Only including
Salvage Charges with P.I Cover as per Clause9
10. CL-344 : Institute Hulls Yacht Clause, ITC Hulls
amended to included P and I
11. Premium Installment Clause
12. CL-311(S) : ITC Hulls amended to include
4by4 Collision as per Clause7 of ITC Hulls Port `k
13. CL-280(S) : ITC Hulls amended to include
4by4 Collision,P and I cover as per Clause 7 and 9
14. CL-280(S) : ITC Hull 1.10.83 with 3by4
collision amended to 4by4

Policy No. : 96000022170100000021Document generated by 17054 at 01/12/2017 16:01:17 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

Page 2 of 3
 THE NEW INDIA ASSURANCE CO. LTD.
(Wholly owned by the Govt. of India)

5 Warranties 1. ISM Code compliance

2. All vessels excluding Tugs and Launches
(excluding Bihar,WB and Assam)
3. For Launches or Passenger vessels (Excluding
Bihar,WB and Assam)
4. For Launches or Passenger vessels employed
in Inland water of Bihar,WB and Assam
5. For Tugs employed in Inland waters of India
(Excluding Bihar,WB and Assam)
6. For Tugs employed in inland water of Bihar,WB
and Assam
7. Classification and Maintanance of class Clause
maintained throughout the policy
8. Trading Warranty
9. Warranted all Statutory requirements and
validity of certificates maintained
10. Warranted Vessel certified and licensed for
trading by competent authority
11. Adverse Weather Warranty
12. Warranted Vessel to comply with local laws
regarding registration and licensing
13. Subject to Ice Clause and Local navigational
rules and regulations complied with
14. All Vsls excluding Tugs and Launches
employed in Inland Water of Bihar,WB,Assam
Premium and GST Details
Rate of Tax Amount`
Premium 441187
SGST 0 0
CGST 0 0
IGST 18 80641

In witness whereof the undersigned being duly authorised by the Insurers and on behalf of the Insurers has (have) hereunder
set his (their) hand(s) on this 01st day of December,2017.

For and on behalf of

The New India Assurance Company
Limited

Duly Constituted Attorney(s)

Mudrank_____________Dt.___________consolidated Stamp Fees Paid by Pay Order Number_______________vide receipt

number___________dt.__________.

Document generated by 17054

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai 400001. TOLL FREE No. 1800 209
1415.

Tax Invoice No : 9600002200000021

IRDA Registration Number: 190

Policy No. : 96000022170100000021Document generated by 17054 at 01/12/2017 16:01:17 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

Page 3 of 3