IRDAI Regn No - 137
CERTIFICATE CUM POLICY SCHEDULE
MOTORISED-TWO WHEELERS PACKAGE POLICY - ZONE A
MOTOR 2 WHEELER (PACKAGE POLICY) - UIN NO. IRDAN137P0017V01200809 - SAC Code. 997134
CIN No. U66010RJ2006PLC029979
Issue Office: 101023 - Address:- C-30,FIRST FLOOR,COMMUNITY CENTRE, NEAR JANAK CINEMA, JANAK PURI,-NEW DELHI NEW
DELHI 110058 Tel 7412078303 / 04 / 05 / 06 / 07
Policy No : 101023/31/19/012484 Prev Policy No 101023/31/18/013446 Geographical Area INDIA
Insured's Code/ Name: 27788328 MR.NARENDER BHALLA
Address: 63,B-BLK,
: VISHNU GARDEN TILAK NAGAR DELHI-DELHI NEW DELHI 110018
Executive: NA0000000169 Agent Details: BB0000000702 GAURAV MADAN / / Contact No: 8700971036
Period of Insurance : From 00:00 on 30/11/2018 To Midnight of 29/11/2019 Cvr Note No. - Issue date
Gross Premium: 2,026 S Tax: 0 GST:364 Cess : 0 Total: 2,390
Registration Engine No Make - Model Type of Body / Cubic Capacity / Date Of Seat Cap
Regn / Delivery
Mark & Place Chassis No Fuel Type Year of Manf (Incl Driver)
DL 9 SBG 3235 76004888 HONDA-ACTIVA 3G SCOOTY 109 21-11-16 1+1
South West Delhi LG7005127 PETROL 2016
IDV For the IDV For side Non Electrical Electrical SI for Named CNG KIT SI Total Value
Vehicle car Accessories Accessories Persons
43,394 0 43,394
A. OWN DAMAGE SCHEDULE OF PREMIUM B. LIABILITY
OD TOTAL 556.00 BASIC TP COVER 720.00
TOTAL PREMIUM 2,026.00 ADD :GR36A-PA FOR OWNER DRIVER 750.00
ADD :CGST 9 % 182.00 TP TOTAL 1,470.00
ADD :SGST 9 % 182.00
FINAL PREMIUM 2,390.00
* NCB discount - 25 % Previous Policy : 101023/31/18/013446 - Previous Insurer : SHRIRAM GENERAL INSURANCE COMPANY LTD
Nominee for PA Owner/Driver : ISHA BHALLA- Age : 29 - Relationship : DAUGHTER - Appointee Name : NA - Appointee Relationship
: NA
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).
Deductibles under Section-I : Compulsory Deductible Rs.100
Subject to IMT Endorsement Printed herein/attached to : IMT-15,IMT-22
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. 100000
P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 1500000
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.
Limitations as to Use
Use only for social, domestic and pleasure purposes and for the insured's business or profession. The Policy does not cover use for hire or reward, tuition, racing, pace making, reliability
trial, speed testing, carriage of goods(other than samples or personal luggage) in connection with any trade or business or use for any purpose in connection with Motor Trade
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 the policy 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 JANAKPURI
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 MVAct, 1988 isrecoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".
POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.
Preinspection Report: SCRATCHED BODY PARTS :As per pi report & photographs dated 29-11-2017 DENTED BODY PARTS :As per pi report & photographs dated 29-11-2017
BROKEN BODY PARTS :As per pi report & photographs dated 29-11-2017- Claim not payable for:
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.
For instant renewal of your insurance policy, Log on to www.shriramgi.com
In case of Claims/Grievance, Please contact us at: Toll Free No - 180030030000, 18001033009 Email id - chd@shriramgi.com
For and on behalf of
SHRIRAM GENERAL INSURANCE COMPANY LTD
Place : NEW DELHI
We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the 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 Challan F10(3946)/COSCHQ/CD,stamp date 19/06/2012 to Collector of Stamps(HQ),Govt of N.C.T.,Delhi
All the Amounts mentioned in this policy are in Indian Rupees Authorised Signatory
Note :-Claim intimation after 48 hours will be
GSTIN No. - 07AAKCS2509K1Z5 considered as delayed intimation. ***DIGITALLY SIGNED
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