Dear MR.

SHANKAR LAL DHAKAD,

Greetings from Mahindra Insurance Brokers!!!

We welcome you to the Ensure by Mahindra family and thank you for choosing our Insurance Program.
Ensure by Mahindra is a specially designed Insurance Program to give you a delightful ownership experience of the Mahindra
vehicle by giving a smooth hassle free experience on your Vehicle Insurance. The Insurance is provided by the Insurance
companies with whom MIBL is associated for selling its products.

The key benefits will be as follows:

‡ Near Cashless facility
‡ Standard and faster Claim settlement
‡ Hassle -free Renewal
‡ Range of Add-on Covers

Your satisfaction is our first priority. Please find enclosed:

‡ Certificate of Insurance (insurance policy)
‡ Policy wordings providing Terms & Conditions

All the above benefits will be available to you at Mahindra Dealer Service Centres. In the unfortunate event of damage to your
Vehicle all you need to do is to get in touch with the Dealer Service Centre or the Insurance Company by dialling on the toll free
number 1800 22 1111

We once again thank you for choosing Ensure by Mahindra.

Best Wishes
Mahindra Insurance Brokers
 SBI General Insurance Co. Ltd.
PRIVATE CAR - PACKAGE POLICY - CERTIFICATE CUM POLICY SCHEDULE CUM
RECEIPT UIN:IRDAN144RP0005V03201112
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Servicing Office of Insurer: Bhopal|2nd Floor , State Bank of India (Main Branch), New Market T.T. Nagar,, Bhopal,
BHOPAL , MADHYA PRADESH-462001 State Code-23
PAN: AAMCS8857L GSTIN: 23AAMCS8857L1ZK Toll Free: 1800 22 1111
Policy No & Policy Issued On MIB/1084281 , 15 Dec 2022 2:39PM Period of Own Damage Cover 15 Dec 2022 2:39PM to 14 Dec 2023 11:59PM (Midnight)
Proposal No. & Date P13635182, 15 Dec 2022 Period of Liability Cover 15 Dec 2022 2:39PM to 14 Dec 2023 11:59PM (Midnight)
Insured Name MR. SHANKAR LAL DHAKAD Period of CPA Cover 15 Dec 2022 2:39PM to 14 Dec 2023 11:59PM (Midnight)
H.NO. 13, JETPURA, TEH- SINGOLI,NEEMUCH, C/O,
Previous Policy No NA
Insured Add. AMARPURA, PO- CHECHI, TEH- BEGUN, (9993626244),
Previous Insurer NA
CHITTORGARH , RAJASTHAN-312023
Insured Contact No XXXXXX4164 Nominee Name PRABHULAL DHAKAD Age 55 Relation FATHER

Make Model Variant Cubic Capacity/GVW/Kw Seating capacity

MAHINDRA & MAHINDRA XUV300 MAHINDRA XUV300 W8 DSL MT SK 1497 5
Vehicle Type Vehicle Sub Class Carrier Type Fuel Type Engine No. Chassis No./VIN
PRIVATE CLOSED DIESEL ETKZG62156 MA1NM2ET1K2G78478
Manufacturing Year RTO Registration No. Registration Date CNG/LPG Kit Trailer Chassis No/VIN
2019 BHILWARA - RJ06 RJ 06 CD 9133 10 Dec 2019 0
Vehicle IDV Body IDV Trailer IDV Non-Elec. Accessories IDV Elec. Accessories IDV Total IDV
750000 0 0 0 0 750000
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A) Liability Premium (B)
Basic Premium Basic Third Party Liability (including TPPD) 3,416
Vehicle 7,180 Third Party Liability For Bi-Fuel Kit 0
Trailer (IMT - 30) 0 Trailer (IMT 30 ) 0
Legal liability to Driver (1) / Cleaner (0) / Helper (0) /
Non-Elec. Accessories 0
Conductor (0) (IMT - 28)
50
Elec. Accessories (IMT-24) 0 PA Cover For Owner Driver (1500000) 325
PA Cover (100000 per person) for Driver(0) /Cleaner(0)
CNG/LPG Kit (IMT - 25) 0 0
/Helper(0) /Conductor(0) (IMT-17)
PA Cover (100000 Per Person) for 4 Unnamed Persons
Sub Total (Basic Premium) 7,180 200
(IMT-16)
Geographical Area Extension (IMT-1) 0 Legal liability to NFPP (0) (IMT- 37) 0
IMT - 34 0 Geographical Areas Extention (IMT - 1) 0
Lamp,Tyre Mudguards (IMT - 23) 0 IMT - 34 TP 0
Net Liability Premium (B) 3991
Add On (Cover for Consumables,Depreciation
8075 Total Premium (A+B) 19,246
Reimbursement,Engine Guard,Roadside Assistance)

Sub Total-Addition 15,255

IGST(18.00%) 3465
Deductibles

Voluntary Deductibles (0) (IMT-22A) 0 Gross Premium Paid 22,711

Anti Theft Device (IMT-10) 0 Note: 1.Policy issuance is subject to realization of cheque
AA Membership (IMT-8) 0 2.Consolidated stamp duty paid to state exchequer
No Claim Bonus (0%) 0 3.The policy is subject to compulsory deductible of Rs.1000 (IMT-22)
Sub Total (Deductibles) 0 4.Geographical Area-India
Net Own Damage Premium (A) 15,255 *Subject to IMT Endt. Nos.& Memorandum:,16,22,28
Hypothecation Details: ----NA----
MISP Details: Name: SHRI KAKAJI AUTOMOTIVES Code: MIBL/M&M/ACTFS3895G/000 Receipt No: 0000001084281 Payment Mode: ACH Reference code: S013491SKA1
Addon Cover(s) UIN: 1) 2) 3) 4)
Limitations as to use: The Policy covers use of the vehicle 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
Limits of Liability: (a) Under Section II-I(i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act,1988. (b) Under Section
II-I(ii) of the policy: Damage to Third Party Property ` 750000/-; PA Cover for Owner-Driver under Section III: CSI ` 1500000/-.
Driver¶s Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or
obtaining such license. Provided also that the person holding an effective learner's license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central
Motor Vehicle Rules, 1989.
Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the company or may call at 1800 22 1111 or may write an email at
customer.care@sbigeneral.in. In case the insured is not satisfied with the response of the office, insured may contact the Grievance Officer of the Company at care@sbigeneral.com.In the event
of unsatisfactory response from the Grievance Office, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance
Ombudsman offices are available at IRDAI website:www.irdai.gov.in , or on the website of General Insurance Council: www.gicouncil.in or on the company website www.sbigeneral.in.
The Policy wording is available on request at free of cost. The Same can be downloaded from our Website www.sbigeneral.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 appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause headed ³AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY´For legal interpretation, English version will hold good.
I/we hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance with the provisions of Chapter X and Chapter XI of Motor
Vehicle Act, 1988
I/ We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are
not required to prepare an invoice in terms of the provisions of the said sub-rule.
HSN : 997134 Description of Service: Motor vehicle Insurance Place of Supply : RAJASTHAN(State Code : 08) Invoice Number : 0000001084281
UIN: IRDAN144RP0005V03201112 For & On Behalf of SBI General Insurance Co. Ltd.
Warranty:Warranted that the insured named herein/owner of the vehicle holds a valid
Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on
the date of commencement of the Policy and undertakes to renew and maintain a valid and
effective PUC and/or fitness Certificate, as applicable, during the subsistence of the Policy.
Further, the Company reserves the right to take appropriate action in case of any
discrepancy in the PUC or fitness certificate.

Authorized Signatory
Broker Name & Corporate Add: Mahindra Insurance Brokers Limited , Ground Floor, Sadhana House, Behind Mahindra Towers, 570 P.B.Marg, Worli, Mumbai- 400018
Email id: insurance.care@mahindra.com Toll Free No: 1800 266 2626 , Mon to Sat from 10.00 AM
License Code No: 261 & Validity: 17-05-2025 CIN:U65990MH1987PLC042609