Mustakeem - Up12t3243

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THE NEW INDIA ASSURANCE CO. LTD.

(Wholly owned by the Govt. of India)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE


Commercial Vehicle Package Policy

UIN Number -

Insured's Details Policy Details


Insured's Name: MUSTAKEEM AND DILSHAD Policy number: 34070031170100010494
Customer ID: PO57829523 (PAN No :NA) Period of cover: 28/02/2018 12:00:01 AM to 27/02/2019
11:59:59 PM
Insureds Address: S/O SH AFJAL AND MR SALEEM, R/O 189, Registration no. UP-12-T-3243
NORTH LADDHAWAL AND 1117, KHALAPAR,
SOUTH CIVIL ,MUZAFFAR NAGAR,,
MUZAFFARNAGAR ,UTTAR PRADESH,
251001
Prev. Policy no. 2315201338636601000 Make/Model: TATA/SFC407 EX (4X4/DSD)
Email: jaimahaveerconsultant@gmail.com Receipt no. 34070081170000012608 - 27/02/18
Phone Number : / / 9897196993 Fax Number : NA / NA

GSTIN/UIN NA / NA
Issuing office New India Contact
Address MUZZARFARNAGAR (340700), Agent / Corp. Agent /
MUZZARFARNAGAR , , , Broker / Banc Mrs. Arpana Jain -
UTTAR PRADESH , 251001. Assurance / Referral
Code - Name / (NIAAG00054648)
POS/IMF
Phone no / / 7060042004
Phone no 01312437342 Fax no. /
Fax no. NA / NA Email /
Email nia.340700@newindia.co.in Development officer DIRECT BUSINESS - (1D7842442)
level Name/Code
Claim Contact MUZZARFARNAGAR (340700) Claim Contact Detail MUZZARFARNAGAR,,;01312437342//
GSTIN 09AAACN4165C4ZM
SAC 997139 (Other non-life insurance services excl RI)
Policy Details
Geographical Area / Zone: India/C Year of manufacture: 2010
Type of Commercial Vehicles: A - Goods Carrying Sub Type: Other than 3 wheeler - Public Carrier
Name of the Financier: TATA MOTORS FINANCE LTD. Chassis no./Engine no.: B05455/605199
Type of fuel: Diesel Cubic capacity ( cc): 0
Type of body: Open Gross Vehicle Weight (GVW): 5700
Seating capacity including Driver: 3 Variant: SFC407 EX (4X4/DSD)
Automobile Association none Colour: OTHER
membership:
Cover Note No/Cover Note Issue / Name of registration authority: Muzaffarnagar
Date:
Transit From NA Transit To NA Distance Covered NA
IDV(In `) Based on annexure-I
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
300000 0 0 0 0 300000
Schedule of Premium
Own Damage Liability
Basic OD Cover Basic TP Cover
LL to paid driver conductor cleaner
employed for oprn
NCB(25%)
OD Premium in ` 1631 TP Premium in ` 14540
Net Premium in `: 16171
GST in `: 2910
Total Payable in `: 19081
Total Payable in `(in words): RUPEES NINETEEN
THOUSAND EIGHTY-
ONE ONLY

Signature Not
Verified
Digitally signed
by Srinivasan Policy No. : 34070031170100010494Document generated by AG_0085678 at 27/02/2018 19:35:53 Hours.
Vaideswaran Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2018.02.27
For 19:35:54
redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
IST
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

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THE NEW INDIA ASSURANCE CO. LTD.
(Wholly owned by the Govt. of India)

Limitations as to use Limits of Liability


The Policy covers use only under a permit within the meaning of the Limit of the amount the Company's Liability Under Section II 1(i) in
Motor Vehicles Act, 1988 or such a carriage falling under Sub-section 3 respect of any one accident: as per the Motor Vehicles Act, 1988. Limit
of Section 66 of the Motor Vehicles Act, 1988.The Policy does not of the amount of the Company's Liability Under Section II 1(ii) in
cover use FOR a)Organised racing b) Pace Making c)Reliability Trials d) respect of any one claim or series of claims arising out of one event:
Speed Testing Up to ` 7,50,000
For individual covers (OD) in `: 300000
Imposed excess in `: 0
Voluntary excess in `: 0
Compulsory excess in `: 500
Persons or classes of persons entitled to drive
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 requirement of Rule 3 of the Central Motor Vehicles Rules, 1989.
PA cover for Owner Driver
Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
NONE 0 NONE NA NA
PA cover for named persons
Name CSI Opted(`) Nominee Relationship
NA NA NA NA

Premium and GST Details


Rate of Tax Amount in INR
Premium ` 16171.00
SGST 9 1455
CGST 9 1455
IGST 0 0

In witness where of this policy has been signed at Mumbai on this 27/02/2018
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to Package/Liability policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,25,40.
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 Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case  the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
I/We hereby certify that the policy to which this Certificate relates as For and on behalf of The New India Assurance Company Limited.
well as this Certificate of Insurance are issued in accordance with
the provisions of Chapter X and XI of M.V. Act, 1988. NIA S.T.REGN
No: AAACN4165CST178.
Date of Issue: 27/02/2018

(Mr. Devendra Kishore)


[Divisional Manager]

Duly Constituted Attorney(s)

Tax Invoice No : 3407003101010494

IRDA Registration Number: 190

Policy No. : 34070031170100010494Document generated by AG_0085678 at 27/02/2018 19:35:53 Hours.


Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

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