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Two Wheeler Package Policy

CERTIFICATE CUM POLICY SCHEDULE

For all your insurance needs & query call us at our Toll free No.: 1800-2666(Accessible from your mobile also), you can also E-mail us at:
customersupport@icicilombard.com
Certificate cum Policy No : 3005/2011309082/B1/0000000008
Name of the Servicing IL Chennai
Branch  
Address of IL Branch   Second and Third Nungambakkam High Road Chottabhai Centre Chennai Tamil Nadu 600034
TAMILNADU-
RTO Location        
Period of Insurance      From 00:00 19/08/2018 To 18/08/2019  midnight TIRUNELVELI
Intermediary Code       200706884448
Insured Name    MARIAPPAN S Policy Issued On   18/08/2018
MURUGAN NO 96/3 ESWARAN KOIL STREET NEDUNKUNDRAM , CHENNAI,
Insured Address         Hypothecated With      
TAMIL NADU, Pin - 600048
Invoice No 17081825069115     
Primary Vertical Name Retail-SHOP AGENCY Category  
Contact No. 91-9884320173(Mobile No.)
Registration    Mfg  Seat Chassis
Make Model Type of body CC Engine Number
Number Year Cap Number
TN72AM0526  TVS  APACHE RTR  Solo With Pillion 148    2012 2 58306 44255
Vehicle IDV Side Car Additional Acc NonElectrical Acc Electrical/Electronic Acc CNG/LPG Unit Total Value
24125     0 0 0 0 0 24125
         SCHEDULE OF PREMIUM 
Own Damage(A) Liability(B)           
Basic Own Damage 339.68    Basic Third Party Liability 720.00   
Total 340.00    PA Cover For Owner-Driver Of Rs. 100000 50.00   
Less
Total 770.00   
No Claim Bonus 50.00 % 169.84   
Sub Total(Deductions): 169.84   
Total Own Damage Premium   170.00     Total Liability Premium   770.00    
Total Package Premium (A+B) 940.00   
Net Premium 940.00  
CGST@9% 84.60  
SGST@9% 84.60  
Total Tax Payable 169.20  
Total Premium   1109.00  
For No claim Bonus (NCB), Coverages and exclusion of policy Please refer to the policy wordings attached with this schedule, in case of you have not received your
kindly write to us at the below mentioned mailing address.
Compulsory Deductibles : Rs.100 GeographicalArea  India *** All Premium figures are in Rupees
PA Owner Driver Nominee Details
Name of Nominee Age  Relationship 
MURUGAN  34  FRIEND 
Limits Of Liability : (a)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.(b)Under Section II-1 (ii)of the policy-> Damage to Third Party Property Rs 100000.00;  PA Cover for Owner-Driver under section III: CSI Rs 100000.00  
LIMITATIONS AS TO USE: The policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal
luggage), Organized racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.
DRIVER'S CLAUSES: 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.
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
Subject to IMT Endorsement Nos. & Memorandum printed herein / attached hereto :    22,28   
Premium Collection Details :
I/We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X,XI of
M.V.Act 1988.

Agency Name: FUTURISK INSURANCE BROKING CO PVT

Agency Code: DB30405
LTD
Agent's Mobile No.: 91-9940302224 Agent's Landline No.:
Disclaimer: Policy is valid subject to Realization of Cheque.
Grievance Clause: 
For resolution of any query or grievance you may contact us on our toll free no.1800-2666, or visit any of our branch offices. You can also write to us at
customersupport@icicilombard.com. For detailed grievance redressal mechanism please visit the “Grievance Redressal” section on our website www.icicilombard.com.

The stamp duty of Re 0.5 paid in cash or by demand draft or by payorder,vide  For   ICICI Lombard General Insurance Company Ltd
receipt/challan no. MH004065018201819M dated 18/07/2018
GSTIN Registration No. : 33AAACI7904G2ZT
HSN/SAC Code: 9971
    
SAC DESC: General Insurance Services  Duly Constituted Attorney(s)
IRDA Registration no. 115 COPY OF POLICY

   ICICI Lombard General Insurance Company Ltd

Mailing Add. Office: ICICI LOMBARD HOUSE, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai 400025.
Corporate Office: ICICI LOMBARD HOUSE, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai 400025.

file://C:\Program Files (x86)\ILPOS Motor Insurance\PolicySchedule.html 18-08-2018