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    Kana Kola
    This document is a certificate and policy schedule for a standalone motor own damage (two wheeler) policy in Zone B. It provides coverage for a 2018 Yamaha YZF R15 motorcycle registered in Andhra Pradesh, with an insured declared value of Rs. 1,17,675. The policy period is from November 28, 2019 to November 27, 2020. The total premium due is Rs. 1,810, which includes a basic premium of Rs. 1,534 along with GST and cess. The policy covers only own damage to the vehicle and provides no liability coverage.

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    CreateDS PDF PDF

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    Kana Kola
    425 views1 page
    This document is a certificate and policy schedule for a standalone motor own damage (two wheeler) policy in Zone B. It provides coverage for a 2018 Yamaha YZF R15 motorcycle registered in Andhra Pradesh, with an insured declared value of Rs. 1,17,675. The policy period is from November 28, 2019 to November 27, 2020. The total premium due is Rs. 1,810, which includes a basic premium of Rs. 1,534 along with GST and cess. The policy covers only own damage to the vehicle and provides no liability coverage.

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    This document is a certificate and policy schedule for a standalone motor own damage (two wheeler) policy in Zone B. It provides coverage for a 2018 Yamaha YZF R15 motorcycle registered in Andhra Pradesh, with an insured declared value of Rs. 1,17,675. The policy period is from November 28, 2019 to November 27, 2020. The total premium due is Rs. 1,810, which includes a basic premium of Rs. 1,534 along with GST and cess. The policy covers only own damage to the vehicle and provides no liability coverage.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    425 views1 page

    CreateDS PDF PDF

    Uploaded by

    Kana Kola
    This document is a certificate and policy schedule for a standalone motor own damage (two wheeler) policy in Zone B. It provides coverage for a 2018 Yamaha YZF R15 motorcycle registered in Andhra Pradesh, with an insured declared value of Rs. 1,17,675. The policy period is from November 28, 2019 to November 27, 2020. The total premium due is Rs. 1,810, which includes a basic premium of Rs. 1,534 along with GST and cess. The policy covers only own damage to the vehicle and provides no liability coverage.

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    © All Rights Reserved
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    of 1

    IRDA Regn No - 137

    Signature Not Verified


    CERTIFICATE CUM POLICY SCHEDULE This Document is Digitally Signed
    Signer : RANJAN KUMAR SAHOO
    POS - STAND-ALONE MOTOR OD (TWO WHEELER) POLICY - ZONE B Date : 12/2/2019 10:13:53 PM
    OD ONLY 2 WHEELER POLICY - UIN NO. IRDAN137RP0003V01201920 - SAC Code. Reason:Signing Policy For SGI

    Issue Office: 417053 - Address:- NO: 19-3-13 (M), 3RD FLOOR, RENIGUNTA ROAD,TIRUPATI, ANDHRA PRADESH.-TIRUPATI
    ANDHRA PRADESH 517501 Tel 7412078365 / 7412078366 / 7412078367
    Policy No : 417053/31/20/007539 Prev Policy No - Geographical Area INDIA
    CIN No. U66010RJ2006PLC029979

    Insured's Code/ Name: 120766153 MR.D MANIGANDAN


    Address: S/O
    : D SUBRAMANYAM,DNO 1-8,KOTHA PALLI MITTA H/W,S R PURAM
    CHITTOOR-CHITTOOR ANDHRA PRADESH 517167
    Executive: NA0000005156 Agent Details: PS0000010643 KOMMINENI SHOBHARANI / / Contact No: 9533334006 PAN No : BYZPK9542H
    Period of Insurance : From 00:00 on 28/11/2019 To Midnight of 27/11/2020 Prop No. - Issue date

    Existing Third Party Policy no.:- 417053/31/19/006258 Period of insurance of TP Policy: From: 28-NOV-18 To: 27-NOV-23
    Name and Address of Third Party Insurer-: SHRIRAM GENERAL INSURANCE , TIRUPATI
    Gross Premium: 1,534 S Tax: 0 GST:276 Cess : 0 Total: 1,810

    Registration Engine No Type of Body / Cubic Date Of Seat Cap


    Make - Model Regn / Delivery
    Mark & Place Chassis No Fuel Type Capacity / (Incl Driver)
    AP 03 CX 1859 G3K5E0047303 YAMAHA-YZF R15 V3 BIKE 155 28-11-18 1+1
    Chittoor ME1RG5219J0041668 PETROL 2018

    IDV For the IDV For side car Non Electrical Electrical SI for Named CNG/LPG SI Total Value
    Vehicle Accessories Persons
    Accessories
    1,17,675 0 1,17,675

    SCHEDULE OF PREMIUM
    OD TOTAL 1,534.00
    TOTAL PREMIUM 1,534.00
    ADD :CGST 9 % 138.00
    ADD :SGST 9 % 138.00
    FINAL PREMIUM 1,810.00
    * NCB discount - 20 % Previous Policy : 417053/31/19/006258 - Previous Insurer : SHRIRAM GENERAL INSURANCE COMPANY LTD

    The above Total OD Premium is inclusive of all applicable Loading/Discounts viz (Automobile Association, Voluntary Excess, Anti-Theft, Handicap Person, Driver Tuition, Fibre Glass,
    CNG/LPG Unit, Geographical Extn, Imported Vehicle etc wherever applicable). ADD-ON : Nil Depreciation Cover.
    Deductibles under Section-I : COMPULSORY DEDUCTIBLE Rs.100
    Subject to IMT Endorsement Printed herein/attached to : IMT-22
    Hypothecation Agreement with: -

    Hire Purchase/Lease Agreement with:


    -
    Driver's Clause
    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.
    Limitations as to Use
    Use only for social, domestic and pleasure purposes and for the insured's business or profession. The Policy does not cover use for hire or reward, tuition, racing, pace making, reliability
    trial, speed testing, carriage of goods(other than samples or personal luggage) in connection with any trade or business or use for any purpose in connection with Motor Trade
    The insurance under this policy is subject to conditions, clauses, warranties, endorsements as per forms attached.Warranted that in case of dishonour of premium cheque(s) the Company shall not
    be liable under the policy and the policy shall be void abinitio (from inception). 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 Motor Vehicles Act, 1988.
    In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at TIRUPATI

    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 appearing in the
    Certificate in order to comply with the MVAct, 1988 isrecoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".

    POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.

    Note: In case of new vehicle, Insured have to submit registration documents within a period of 15 days from the date of issue of Registration Certificate of Vehicle.

    This Policy covers only Own Damage Risk with no other Liability in connection with Two Wheeler vehicle including third party cover.

    In case of Claims, Please contact us at: Toll Free No - 180030030000, 18001033009 Email id - chd@shriramgi.com

    For and on behalf of


    SHRIRAM GENERAL INSURANCE COMPANY LTD

    Place : TIRUPATI Date : 27/11/2019


    We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the expiry date of
    your policy. If you do not want us to contact you, kindly send an e-mail for the same on dnd@shriramgi.com

    All the Amounts mentioned in this policy are in Indian Rupees Authorised Signatory
    Note :-Claim intimation after 48 hours will be
    GSTN No. - 37AAKCS2509K1Z2 considered as delayed intimation. ***DIGITALLY SIGNED
    Page 1 of 1

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