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

POS - MISCELLANEOUS CLASS D VEHICLES - TRACTORS - Zone C
MOTOR COMMERCIAL VEHICLE (PACKAGE POLICY) -
UIN No.IRDAN137RP0018V01200809 - SAC Code: 997134

Branch Address Shriram General Insurance Co Ltd.Shop No. Branch Office Phone No.
F9-10, Ward No.30,, Gandhi Nagar, CMC
Colony, Kailash Nagar, Manalli, Main Road,,
CIN NO.U66010RJ2006PLC029979

Bidar - 585401 (Karnataka), BIDAR,

KARNATAKA - 585401
Geographical Area INDIA Policy No. 418063/31/25/001024
Insured's Code/ Name IN-35028836 / MR. SHEKARAREDDI GSTIN No. Of Insured Unregistered
Insured Address S/0 PUNDARADDEPPA MADINUR R/0 SIRUR, YELBURGA
, SIRUR
, KOPPAL, KARNATAKA
- 583230
Insured State Code 29 NCB Discount (%) 0
Executive SANGAMESH - NAN000001707 Period of Insurance From 17:04 Hrs of 26/09/2024 To
Midnight Of 25/09/2025
Agent Details NAGALAXMI - PSN000016334- Mobile No.-
9591690617- Toll/Phone No.N.A
PAN No. BGLPN3955R
Prop No. - TR No. N.A - N.A Prop Issue Date N.A
Gross Premium 9530 IGST 0
CGST 858 SGST/UTGST 858
Previous Insurer N.A. Total 11246
Previous Policy No. N.A Nominee for Legal Heir
Owner/Driver
Nominee Age 43 Nominee Relationship OTHERS
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 /
WATT/
YEAR OF
MANF.
NEW & CJ.1354/ADO01313 & MAHINDRA AND TRACTOR / 1/0/ 0 25/09/2024 0+1
KOPPAL MBNAK48ACRTE28555 MAHINDRA - SWARAJ DIESEL 2024
735 FEE R
Charger No. Battery Number Motor Number
IDV FOR THE IDV FOR TRAILER NON ELECTRICAL ELECTRICAL CNG/LPG kit SI TOTAL VALUE
VEHICLE ACCESSORIES ACCESSORIES
693500.00 0 0 0 0 693500.00
Own Damage Policy Period Liability Policy Period
From Date & Time 26/09/2024 To Date & Time 25/09/2025 23:59 From Date & Time 26/09/2024 To Date & Time 25/09/2025 23:59
17:04 Hrs Hrs of Midnight 17:04 Hrs Hrs of Midnight
SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
OD TOTAL 1898.00 BASIC TP COVER 7267.00
TOTAL PREMIUM 9530.00 ADD :GR36A-PA FOR OWNER DRIVER 315.00
ADD : SGST/UTGST 9.00% 858.00 ADD :Legal Liability Coverages For Paid Driver 50.00
ADD : CGST 9.00% 858.00 TP TOTAL 7632.00
PREMIUM AMOUNT 11246.00
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 17:04
Hrs of 28/09/2024 To Midnight of 27/09/2025

CPA Policy number: , CPA Sum Insured: 0.00, CPA Company Name: , CPA Valid From: N.A., CPA Valid To: N.A.
Deductibles under Section-I : Compulsory Deductible Rs.3468
Subject to IMT Endorsement Printed herein/attached to : IMT-23, IMT-28, IMT-21.
Hypothecation Agreement with:
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

PLACE : BIDAR
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 order No. F7(77)Gen/2023/4956 dated 20/07/2023
Policy Issuing office - E-8, EPIP, RIICO INDUSTRIAL AREA, SITAPURA ,JAIPUR, RAJASTHAN, 302022
For Policy Wordings, NEFT/RTGS/IMPS or any other online payment kindly visit our website
"www.shriramgi.com" Validity of policy is subject to KYC verification.
Note :- Claim intimation after 48 hours will be
considered as delayed intimation.
All the Amounts mentioned in this policy are in Indian Rupees
GSTIN No. 29AAKCS2509K1ZZ Authorized Signatory

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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

POS - MISCELLANEOUS CLASS D VEHICLES - TRACTORS - Zone C
MOTOR COMMERCIAL VEHICLE (PACKAGE POLICY) -
UIN No.IRDAN137RP0018V01200809 - SAC Code: 997134
Attached to and forming part of policy number : 418063/31/25/001024
PreInspection Survey: Dented Part : N.A,Broken Part : N.A, Scratched Part : N.A ,Claim not payable for : N.A
Preinspection Report: Not Applicable
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. When the vehicle is used for transport of goods add the following words : -
when not used for the transport of goods at the time of the accident ** When the vehicle is used for transport of passengers add the following words: -
when not used for the transport of passengers at the time of the accident
Limitations as to Use:
Use in connection with the insured's business The Policy does not cover 1) Use for hire or reward or for racing, pace making, reliability trial or speed
testing, 2) Use whilst drawing a trailer except the towing (other than for reward) of any one of disabled mechanically propelled vehicle
The Policy covers use only under a permit within the meaning of the Motor Vehicle Act, 1988 or such a carriage falling under Sub-section 3 of Section 66
of the Motor Vehicle's Act 1988 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 thepolicy 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 BIDAR

IMPORTANT NOTICE:
The Insured is not Indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule.
POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.

If policy is cancelled/Endorsed beyond the said date [i.e.31/10/2025],only the proportionate amount of premium would be refunded and any GST amount would
NOT be refunded owing to the restrictions prescribed under GST law.
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/Grievance, Please contact us at: Toll Free No – 180030030000, 18001033009 Email id - chd@shriramgi.com
For instant renewal of your insurance policy, Log on to www.shriramgi.com or contact us at our Head office no. - 0141-4828400

PLACE : BIDAR
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 order No. F7(77)Gen/2023/4956 dated 20/07/2023
Policy Issuing office - E-8, EPIP, RIICO INDUSTRIAL AREA, SITAPURA ,JAIPUR, RAJASTHAN, 302022
For Policy Wordings, NEFT/RTGS/IMPS or any other online payment kindly visit our website
"www.shriramgi.com" Validity of policy is subject to KYC verification.
Note :- Claim intimation after 48 hours will be
considered as delayed intimation.
All the Amounts mentioned in this policy are in Indian Rupees
GSTIN No. 29AAKCS2509K1ZZ Authorized Signatory

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