8/14/24, 6:43 PM Maruti Suzuki Insurance

ROHAN MOTORS LIMITED

The Policy is sourced and serviced by:

Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110070

This is not a part o f t h e p o l i c y d o c u m e n t, Please Detach here

Universal Sompo General Insurance Co. Ltd

IRDAI Reg. No. 134. CIN - U66010MH2007PLC166770

ORIGINAL FOR RECIPIENT / DUPLICATE FOR SUPPLIER

TAX INVOICE/CERTIFICATE CUM POLICY SCHEDULE
(FORM 51 OF THE CENTRAL MOTOR VEHICLES RULES, 1989)
Annual Liability only policy &
Policy Type & UIN: Proposal No & Date R0000003867 / 14-AUG-2024 17:12
IRDAN134RP0005V01202122
Policy No 2319/74673148/00/000
Period of Insurance 16-AUG-2024 00:00 to 15-AUG-2025 23:59
Policy Issued On 14-Aug-2024 17:25
Insured Name Mr. Shyamveer Singh Sirohi Vehicle Identification No. MA3EWDE1S00142910
Invoice No 09MI240323414 Geographical Area India
S/O SH RAJENDRA SINGH , H.NO.-30 , VILLAGE - GST No & State NA | Uttar Pradesh
Insured Address AKBARPUR RAINA , POST-AGAUTA, .. -, BULANDSHAHR
Accounting Code of Service 997134
UTTAR PRADESH-203001
Insured State &
Uttar Pradesh-09 Place of Supply Uttar Pradesh GSTIN of Customer GSTUNREGISTERED
Code
Motor Vehicle Details
Make Maruti Suzuki Seating Capacity 5
Model - Variant WagonR New Vxi Type of Body | Colour Hatchback | SILVER SILKY METTALIC
Registration No UP13X0919 Fuel Type Petrol
Year of Manufacture 2010 RTO Location BULANDSHAHAR
Engine-Chassis No. K10BN4103111 - MA3EWDE1S00142910 Zone B
Cubic Capacity 998 FASTag ID
Insured Declared Value (₹)
Vehicle ₹ 0 Non Electrical Accessories ₹ 0 Electrical Accessories ₹ 0 CNG/ LPG Kit ₹ 0 Total IDV ₹ 0
Schedule Of Premium (Amount In ₹)
Liability Section(B)
Basic Third Party Liability ₹ 2094
Compulsory PA Cover Premium [1 Year] ₹ 225
Legal Liability (WC) to Driver (IMT-28) ₹ 50
Net Liability Premium (B) ₹ 2,369
Total Premium (A+B) ₹ 2,369
CGST @9% ₹ 213.21
SGST @9% ₹ 213.21
Gross Premium Paid ₹ 2,795
MISP - ROHAN MOTORS LIMITED
Notes: -
1. Policy Issuance is subject to realisation of premium.
2. Consolidate stamp duty paid to State Exchequer
3. Subject to Endorsements IMT 28, ,
4. Policy has been issued subject to valid Pollution Under Control (PUC) Certificate declared by you as an insured on or before the date of commencement of the Policy
5. Warranted that the insured named herein/owner of the vehicle holds a valid Pollution Under Control (PUC) Certificate, as applicable, on the date of commencement of the Policy and undertakes to
renew and maintain a valid and effective PUC, 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.

Nominee Details
Nominee Name: MR. HEMANT SIROHI Age: 43 Relation: Son-in-Law
Financer Details
Financer Type: NonFinance Financer Name: N/A Financer Branch: N/A
Payment Details
Payment Mode: Auto Debit Cheque No/Transaction No: Bank Name: HSBC BANK LTD Amount: 2,795
162100110844575
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.
Driver: 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.
Limits of Liability: Under Section II-1 (i) of the policy - Death of or bodily injury - Such amount as is necessary to meet there requirements of the Motor Vehicles Act, 1988. Under Section
II -1(ii) of the Policy - Damage to Third Party Property - Rs.750000 - (as per IMT 20)in respect of any one claim or series of claims arising out of one event. Cover for Owner - Driver under
section III (CSI) Rs 1500000 - Deductible under section-I : Rs 1000(Compulsory Deductible Rs 1000 Imposed Deductible Rs. 0 and Voluntary Deductible Rs 0)
No Claim Bonus: : The insured is entitled for a No Claim Bonus (NCB) on the Own Damage section of the policy, if no claim is made or pending during the preceding year (s), as per the
following: The preceding year/20%, Preceding Two consecutive years/25%, Preceding Three consecutive years/35%, Preceding Four consecutive years/45%, Preceding Five consecutive
years/50%. No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
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 "AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY". For Legal interpretation, English version will hold good.
For information on ombudsman you may visit website : https://www.cioins.co.in/Ombudsman
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 M.V. Act,
1988.

For Universal Sompo General Insurance Co. Ltd

Authorised Signatory

Policy Issuing Office : Office No 401,Shalimar Logix,4 Rana Pratap Marg,Lucknow -226001.
GSTIN: 09AAACU8917F1Z4, CIN No: U66010MH2007PLC166770. State Name : Uttar Pradesh
This Policy is sourced and serviced by Maruti Suzuki Insurance Broking Private Limited
Direct Broker (General) IRDAI License No. 428, valid till – 01 February 2027, Mail ID: support@msibpl.co.in, Contact: 33774477 (Prefix 011/022/033/044)

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8/14/24, 6:43 PM Maruti Suzuki Insurance

For Policy Terms and Conditions Log on to : www.marutisuzukiinsurance.com,

ROHAN MOTORS LIMITED

www.universalsompo.com

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8/14/24, 6:43 PM Maruti Suzuki Insurance

ROHAN MOTORS LIMITED

The Policy is sourced and serviced by:

Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110070 This is not a part of the policy document, Please Detach here

Original Certificate of Insurance must be carried in your Car

Carry the Original certificate of insurance with the vehicle at all times - this is mandatory and is an evidence of
compliance with Motor Vehicle Act 1988.

Want to change anything in your policy?

Visit your nearest Dealership or get in touch with Maruti Suzuki Insurance Broking at their dedicated customer support -
DIAL 3377 4477 (prefix 011 / 022 / 033 / 044) to update your contact details, address, any change in the vehicle
ownership, CNG/ LPG status, accessories addition/deletion etc.

Is your policy falling due for Renewal?

To renew your policy you may: 1) Visit www.MarutiInsurance.com 2) Visit Nearest Dealership 3) Call us at 011 3377
4477 4) SMS RENEW to 9215292152.

What to do if your four wheeler meets with an accident?

Simply inform Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 / 033 / 044) or Visit
www.MarutiInsurance.com to locate nearest Dealership. They will assist you with your claim intimation to us and will
also help you with other formalities. In case you intend to make a claim on your policy, please ensure that the claim is
intimated to Maruti Suzuki Insurance Broking within 24 hours of accident or on the next working day.

What should you do if there is a third party injury/death and/ or third party property damage?
Lodge an FIR with the nearest Police station and obtain a copy. Provide a photocopy of your insurance policy to the
affected third party. It is not necessary to compensate the affected third party on the spot. Inform Maruti Suzuki
Insurance Broking at 3377 4477 (prefix 011 /022 / 033 / 044) for further assistance.

Is your Vehicle Stolen?

Lodge an FIR at the nearest Police Station and obtain a copy of the FIR. Inform Maruti Suzuki Insurance Broking at 3377
4477 (prefix 011 / 022 / 033 / 044). Maruti Suzuki Insurance Broking will guide you for proper filing of your claim
towards a quick settlement.

Total Loss Claim?

As a convention, it is called a total loss when the damages are so severe that claim assessment (Survey) indicates that
the vehicle is beyond repairs OR it shows that the Insurance Co.’s liability is more than 75% of two wheeler’s insured
declared value. Visit your nearest Dealership or just inform Maruti Suzuki Insurance Broking at 3377 4477 (prefix
011/022/033/044) and you will be guided for a quick claim settlement.

Avoid driving through water log areas!

It can cause damage to your vehicle both internally and externally. Please do not try to start your car in case your vehicle
stops by getting submerged in flood or while crossing a water logged area. This can cause severe damage to the engine
which is called Consequential Loss and is not covered in your policy.

Must to Know
This Policy does not cover damage due to consequential loss, Wear & Tear, Mechanical/Electrical Breakdown, Driving
under the influence of liquor or drugs, Contractual Liability, Driving without valid driving license, Usage outside
specified geographical area, Nuclear or War perils. It does not cover Damage to tyres (unless vehicle is also
damaged).
A Compulsory deductible based on Vehicle CC as per India Motor Tariff will apply at the time of every claim.
Depreciation on parts as per India Motor tariff will apply at the time of every claim unless opted for zero depreciation
cover.
In case of Zero Depreciation Policy, the benefit of Zero Depreciation would be applicable for specific number of claims
as per the Insurance Company's Terms & Conditions.
AC Gas is fully payable. All Oils/Brake Lining/Glass Sealants/Oil Air Filters are paid @ 50%. Coolant/Fastener are not
payable.
Visit Maruti Suzuki Insurance Broking at www.MarutiInsurance.com

Be Safe : Your Safety is Our Concern

Don’t Mix Drinking and Always Keep Your Vehicle In

Follow Traffic Rule
Driving Good Condition

Please Use Child Seats

Pedestrians Have First Always Wear Your Seat
When Children are Seated in
Priority on Roads Belts
Front of Airbags

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