IRDAI REGN. NO.

- 137
SHRIRAM GENERAL INSURANCE COMPANY LIMITED
E-8,EPIP,SITAPURA INDUSTRIAL AREA,JAIPUR,
RAJASTHAN-302022
B
CONTACT(TOLL FREE): 1800 – 30030000, 1800 – 1033009

CERTIFICATE CUM POLICY SCHEDULE

GCCV-PUBLIC CARRIERS OTHER THAN THREE WHEELERS - Zone C
MOTOR COMMERCIAL VEHICLE (PACKAGE POLICY) -
UIN No.IRDAN137RP0018V01200809 - SAC Code: 997134

Issue Office 10003-Address-E - 8, RIICO Issue Office Phone No.

INDUSTRIAL AREA, SITA PURA, JAIPUR,
RAJASTHAN -302022
Geographical Area INDIA Policy No. 10003/31/22/125511
CIN NO.U66010RJ2006PLC029979

Insured's Code/ Name IN-23043628 / GSTIN No. Of Insured Unregistered

SHAVUKULA VENKATAIAH
Insured Address HNO-2-51 YARENPALLE KONGATPALLY
HANWADA, MAHABUB NAGAR, TELANGANA
- 509334

Insured State Code 36 NCB Discount (%) 45

Executive IDHARMARAO - NC0000000011 Period of Insurance From 09:47 Hrs of 20/12/2022 To
Midnight Of 19/12/2023
Agent Details M/S.STFC LTD - CA0197 - BG0000000003-
Mobile No.-N.A
PAN No. N.A
Prop No. - TR No. N.A - N.A Prop Issue Date N.A
Gross Premium 42000 IGST 6050
CGST 0 SGST/UTGST 0
Previous Insurer Total 38,502

Previous Policy No. 10003/31/21/260500 Nominee for RADHAMMA

Owner/Driver
Nominee Age 52 Nominee Relationship Mother
Appointee Name N.A Appointee Relationship N.A
REGISTRATI ENGINE NO. & CHASSIS NO. MAKE - MODEL TYPE OF BODY CUBIC G.V.W DATE OF REGN. / SEAT CAP.
ON MARK & / FUEL TYPE CAPACI DELIVERY (INCL. DRIVER)
PLACE TY/
YEAR OF
MANF.
AP - 21 - Y - NPH505550 & PNE640591 ASHOK LEYLAND LTD OPEN 2008 28000 03/03/2008 3
2014 & TUSKER 2214/S / DIESEL
MAHABOOB
NAGAR
Battery Number Motor Number

IDV FOR THE IDV FOR TRAILER

NON ELECTRICAL ELECTRICAL CNG/LPG kit SI TOTAL VALUE
VEHICLE ACCESSORIES ACCESSORIES
302694.00 0 0 0 0 302694.00
Own Damage Policy Period Liability Policy Period
From Date & Time 20/12/2022 To Date & Time 19/12/2023 23:59 From Date & Time 20/12/2022 To Date & Time 19/12/2023 23:59
09:47 Hrs Hrs of Midnight 09:47 Hrs Hrs of Midnight
SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
OD TOTAL 4458.00 BASIC TP COVER 38037.00
TOTAL PREMIUM 31960.00 ADD :GR36A-PA FOR OWNER DRIVER 315.00
ADD : IGST 18.00% 886.00 ADD :Legal Liability Coverages For Paid Driver 150.00
ADD : IGST 12.00% 2164.00 TP TOTAL 38502.00
PREMIUM AMOUNT 38010.00
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 ). PA Owner Driver CoverPeriod:- From 00:00
Hrs of 20/12/2022 To Midnight of 19/12/2023

CPA Policy number: N.A., CPA Sum Insured: 0.00, CPA Company Name: N.A., CPA Valid From: N.A., CPA Valid To: N.A.
Deductibles under Section-I : Compulsory Deductible Rs.1500
Subject to IMT Endorsement Printed herein/attached to : IMT-28, IMT-40, IMT-7, IMT-21.
Hypothecation Agreement with: SHRIRAM TRANSPORT FINANCE CO.LTD
Hire Purchase/Lease Agreement with:
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
PreInspection Survey: Dented Part : N.A,Broken Part : N.A, Scratched Part : N.A ,Claim not payable for : N.A
Preinspection Report: Not Applicable

PLACE : HEAD OFFICE-III

For and on behalf of
We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the Shriram General Insurance Co.Ltd.
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
Consolidated Stamp Duty paid vide Inspector General Registration and Stamp Ajmer order No. F7
(77)Gen/2021/Part-I/9239 dated 20/12/2022
For Policy Wordings, NEFT/RTGS/IMPS or any other online payment kindly visit our website
"www.shriramgi.com".

All the Amounts mentioned in this policy are in Indian Rupees Note :- Claim intimation after 48 hours will be
GSTIN No. 08AAKCS2509K1Z3 considered as delayed intimation.

Authorized Signatory
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