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Policy Issuing Office Muzaffarpur Division ,P and T Chowk, Gaushala Road, Muzaffarpur, Bihar, Pin : 842002

Tel: 0621 2244711 (D) 2245357 (G) , 2240661 Fax: 06212244711 Email:

CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE

New Policy
Policy No: 17060031156160000191 Package (Private Car) RTA
[Issued on 29-May-2015] Regional Transport Officer, Muzaffarpur Bihar

THE INSURED: Name : MR.PRAMOD KUMAR


Address : S/O SRI MOJE LAL SAH, AT- B.HASSAN, PO- V.PANDAY, MUZAFFARPUR
Pincode : 843111 Profession / Business : Businessmen

Period of Insurance From : 31/05/2015 00:00:00 to midnight on : 30/05/2016


Vehicle Make: Hyundai i10 1.2 Kappa Magna MT
Geographical Engine- no Chassis- no Type of Body CC Mfg. SeatingCapacity Registration No.
Area Year / G.V.W.
INDIA G4LABM623741 MALAM51CLBM87 2023*C Saloon 1197 2011 5 BR-06-Y-6003
INSURED DECLARED VALUE Extension : No Extension
Vehicle Non Electrical Electrical CNG/LPG Kit IDV of Trailer Total IDV
Accessories Accessories
Rs. 2,70,394 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 2,70,394
Schedule of Premium
Net Premium : Rs. 7,199
Service Tax @ 12.36 % Rs. 890
Total Premium : Rs.8,089

NOTE:
1. Warranted that in case of dishonour of the premium cheque, this document stands automatically cancelled 'AB-INITIO'.
2. Consolidated Stamp duty paid.

Compulsory Excess: Rs. 1,000 Imposed Excess : Rs. 0 Voluntary Excess : Rs. 0 StampDuty : Re. 1

Nominee Details of Compulsory PA:


Nominee Name Relationship Nominee Age Name of Appointee Relation of Appointee
ANJU DEVI Spouse 32

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 and Reliability Trials f) Use in connection with Motor
Trade
Drivers Clause : Any person including Insured Provided that a person driving holds an effective driving licence at the time of the accident and
is not disqualified from holding or obtaining such a licence. Provided also that the person holding an effective Learner''s Licence may also
drive the vehicle and such a person satisfies the requirements of Rule 3 of Central Motor Vehicles Rules, 1989.
Limits of Liability Clause: Under section II 1 (i)of the policy-Death or bodily injury.Such amount as is necessary to meet the requirements of the
motor vehicle act 1988.under section II 1 (ii)of the policy -Damage to third party property is Rs.7,50,000 PA Cover under section 3 for
owner-driver is Rs. 2.0 lakhs.
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 preceeding year(s),as follows : The preceding year/20%, preceeding two consecutive years/25%, preceeding three consecutive
years/35%, preceeding four consecutive years/45%, preceeding five consecutive years/50% of NCB on OD Premium. No Claim bonus only be
allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
Financier Name Others Financier's Pin Code 842001
Financier's Branch Details MAGMA FINCORP LTD. MUZAFFARPURFinancier Type Hypothecation
Subject to I.M.T Endt. printed herein/attached hereto : 7, 22, 28
The Insured is not indemnified if the vehicle is used or driven I/We hereby certify that this Certificate cum Schedule of Insurance
otherwise than in accordance with this schedule.Any payment issued in accordance with the provisions of chapter X and chapter XI of Motor
made by the company by reasons of wider terms appearing in Vehicles Act,1988 For & On behalf of the National Insurance Company
the certificate in order to comply with the Motor Vehicles Limited
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 Authorised Signatory
good

CIN No: U10200WB1906GOI001713, IRDA Regn. No:58


Collection Number : 17060081158000000208 Collection Date : 29-May-2015
Service Tax Registration No : AAACN 4165 CST 178

Registered Office
3, Middleton Street, Post Box No. 9229, Kolkata - 700 071

balaji_hyundai 29/05/2015 10:31:38 A.M. -1-


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