DEVELOPMENT HOUSE, 24 Park Street , Kolkata -700016

In case of any query, assistance or claims, please contact us at 1800 266 3202
UIN: IRDAN149RP0006V02201213

COMMERCIAL VEHICLE CLASS (GCV) PACKAGE POLICY

CERTIFICATE OF INSURANCE CUM SCHEDULE /TAX INVOICE
Policy Servicing Office G-2, GROUND FLOOR, MANDHANA TOWERS, 7-1-59/2 & 59/6, ,AMEERPET, ,HYDERABAD -500016 ,TELANGANA , PH: (1800) 2663202
Policy No P0023300035/4103/102357
Insured Mr MODH ARIF
Address S/O MODH AKBAR H,NO;5-26, AKBAR NAGAR KUNDANPALLE Period Of Insurance 00:00 Hrs of 26/01/2024
RAMAGUNDAM, PEDDAPALLE To Midnight of 25/01/2025
KARIMNAGAR LAVANYA MADDELA-POS0001695-AHMPM9887E-
Agent No.:
TELANGANA 505208 XXXXXXXX8702
Mobile:8639827114
Contact Number 8639827114 Hypothecation with CHOLAMANDALAM INV & FIN CO LTD
Email ID:
GST Number Unregistered
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Registration Mark
Trolley Serial Trolley Chassis Year of
& No. & RTA Engine No. Chassis No. Make/Model/Type of Body GVW POLICY CLASS SEATING CAPACITY
ID No. Manufacture
Location
TS 22 T 7311 / MAHINDRA TUV300 T10 A1 GCV Public
2019 4SPCR10PPY646678 MAT464603KSP14893 2950 Carriers other 7
PEDDAPALLI
than 3 wheelers
IDV (INSURED'S DECLARED VALUE)
Electrical/electronic
IDV of Chassis IDV of Body Trailers Non Electrical Accessories Bi-Fuel kit(LPG/CNG) Other accessories Total Value
Accessories
400000 0 0 0 0 0/0 0 400000
OWN DAMAGE(A) LIABILITY(B)
Basic - OD 1,380.80 Basic - TP 16,049.00
Loss/damage to lamps/tyres/mud guards etc. - IMT-23 207.12 PA for Paid Drivers Cleaners and Conductors - IMT 17 60.00
Sub Total 1,587.92 Under WC act-Driver/cleaner/employees-IMT 28 200.00
Total Own Damage Premium(A) 1,588.00 Sub Total 16,309.00
CGST @ 9% 142.92
SGST @ 9% 142.92

Total Liability Premium(B) 16,309.00

GST on TP Premium
CGST @ 6% 962.94
SGST @ 6% 962.94
GST on Other Liability Premium
CGST @ 9% 23.40
SGST @ 9% 23.40
Premium Computation
Total Package Premium(A+B) 17,897.00
TOTAL CGST 1,129.26
TOTAL SGST 1,129.26
TOTAL 20,156.00
Disclaimer:The Exclusions in this policy are as specified in the pre inspection report ID :
LIMITATIONS AS TO USE - The Policy covers use only under a permit within the meaning of the Motor Vehicles Act, 1988 or such a carriage falling under Sub-section 3 of
Section 66 of the Motor Vehicle's Act 1988.
The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a trailer except the towing (other than for reward) of any one
disabled Mechanically propelled vehicle (only for Passenger Carrying Vehicles).
Persons or classes
of persons entitled Any person including Insured:
to drive:
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 a license.Provided also that the
Goods carriage person holding an effective learner's license may also drive the vehicle when not used for the transport of passengers at the time of the accident and that such a person satisfies
the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989.
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 a license.Provided also that the
Non-transport
person holding an effective learner's license may also drive the vehicle when not used for the transport of passengers at the time of the accident and that such a person satisfies
Vehicles
the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989.
LIMITS OF LIABILITY
Under Excess in respect of each and every claim under Sec I of Under In respect of any one Under Damage to Third Party Property Rs. Under PA Owner – Driver as per
Section I motor policy Section accident -- As per Section 750000/- in respect of any one claim Section III: premium computation
Compulsory : Rs. 500/- Voluntary : Rs. 0/- Imposed : II-I (i) Motor Vehicle Act II-I (ii) or series of claims arising out of one table
Rs. 0/- Total : Rs. 500/- event.
Subject to I.M.T Endorsement Nos. IMT 7,IMT 17,IMT 21,IMT 23,IMT 28
Pollution Under Control(PUC)
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 at the time of issuance of policy.

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.
Premium Collection Details :- [Collection No - ReceiptDate - Amount] : P/300035/23/100995992- 24/02/2023 , 20156
Premium Amount in Word's ( ) :- Twenty Thousand One Hundred Fifty-Six Only
In case of Claims, please contact us at 1800 266 3202 For Magma HDI General Insurance Co. Ltd.

Date of Issue : 25/01/2024

Place : Kolkata
Consolidated Stamp Duty on the issue of General Insurance Policies Paid vide G.O No. 1662, dated 29.09.2022

GST Number of MHDI - 36AAGCM1685C1ZK

GST Invoice Number - POL3602230004113
Accounting Code for Service - 997134, Motor vehicle insurance services

Place of Supply:TELANGANA ( 36 )

Whether Tax is payable on Reverse Charge - No Authorised Signatory

UIN : IRDAN149RP0006V02201213
This is a valid Tax invoice in terms of Sub-rule 2 of Rule 54 of CGST Rule 2017. Further, being an Insurance Company, issuing of e-
invoice and QR Code are not applicable on us in terms of Notification No 13 and 14 of 2020 dated 21st March 2020 issued from
Central Board of Indirect Taxes and Customs. 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.
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 be good. Please note that any misrepresentation, non disclosure or withholding of material facts will lead to cancellation of policy ab initio with forfeiture of premium
and non consideration of claim, if any.
For Complete details of coverage , terms, conditions & exclusion please refer the standard policy wording attached with this schedule

IMPORTANT - 1) The Validity of this Certificate of Insurance cum Schedule is subject to realisation of the premium cheque.
2) No Claim Bonus will only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy.
3) This document is digitally signed, hence counter signature / stamp is not required.