IRDA Regn No - 137

CERTIFICATE CUM POLICY SCHEDULE

POS - LONG TERM TWO WHEELER - NEW BUNDLED POLICY - ZONE B
BUNDLED MOTOR 2 WHEELER POLICY - UIN NO. IRDAN137RP0007V01201819 - SAC Code.
Issue Office: 108056 - Address:- SHRIRAM GENERAL INSURANCE CO. LTD RADHIKA BHAWAN OPP PADMINI HOTEL REWA
RANCHI NH 75 E MURDHAWA- UTTAR PRADESH 231217 Tel 7412079615 / 7412079614
Policy No : 108056/31/20/008844 Prev Policy No - Geographical Area INDIA
CIN No. U66010RJ2006PLC029979

Insured's Code/ Name: 120720643 Mr.AJAY KUMAR CHANDRAVANSHI

Address: VILL
: PO HARIHARPUR, PS BHAWANATHPUR -GARHWA JHARKHAND 822114
Executive: NA0000002375 Agent Details: PS0000018676 SUNITA SONI / / Contact No: 9472523914 PAN No : GCJPS5937R
Period of Insurance : OD: From 12:51 on 26/11/2019 To Midnight of 25/11/2020 Prop No. - Issue date
TP: From 12:51 on 26/11/2019 To Midnight of 25/11/2024 PA Owner Diver CoverPeriod:- 26-NOV-19 TO 25-NOV-20
Gross Premium: 3,652 S Tax: 0 GST:657 Cess : 0 Total: 4,309

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

Make - Model Regn / Delivery
Mark & Place Chassis No Fuel Type Capacity / (Incl Driver)
NEW KF1LK1908213 TVS-RADEON BIKE 110 26-11-19 1+1
Garuwah MD625HF18K1L04000 PETROL 2019

IDV For the IDV For side car Non Electrical Electrical SI for Named CNG/LPG SI Total Value
Vehicle Accessories Persons
Accessories
45,000 0 45,000

A. OWN DAMAGE SCHEDULE OF PREMIUM B. LIABILITY

OD TOTAL 302.00 BASIC TP COVER 3,285.00
TOTAL PREMIUM 3,652.00 ADD :GR36A-PA FOR OWNER DRIVER 315.00
ADD :IGST 18 % 657.00 LESS :GR39A-TPPD COVER 250.00
FINAL PREMIUM 4,309.00 TP TOTAL 3,350.00
* NCB discount - % Previous Policy : NA Nominee for PA Owner/Driver : PUJA DEVI- Age : 20 - Relationship : Spouse - Appointee
Name : NA - Appointee Relationship : NA
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).
Deductibles under Section-I : COMPULSORY DEDUCTIBLE Rs.100
Subject to IMT Endorsement Printed herein/attached to : IMT-15,IMT-20,IMT-22,IMT-6
Hypothecation Agreement with: -

Hire Purchase/Lease Agreement with:

TVS CREDIT SERVICE PVT LTD
-
Limit of Liability :
Under Section II-1(i) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-1(ii) in respect of any one claim or series of claims arising out of one event is Rs. 750000
P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 1500000

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 RENUKOOT

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.
Preinspection Report: Not Applicable
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.

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 : Date : 26/11/2019

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. - 09AAKCS2509K1Z1 considered as delayed intimation.
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