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    Intermediary Code: Intermediary Name: Contact:: BR150000 Probus Insurance Brokers Ltd. 18008336700

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    vansham malik
    This document is a certificate of insurance and policy schedule for a private car liability only policy. It provides insurance coverage from July 24, 2021 to July 23, 2022 for Mr. Bhupesh Sardana's 2016 Maruti Celerio registered in Delhi. The policy covers liability for death, bodily injury, and property damage up to the amounts required by law. It also includes a personal accident coverage of Rs. 15 lakh for the owner-driver. The total premium due is Rs. 2,887.46.

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    Intermediary Code: Intermediary Name: Contact:: BR150000 Probus Insurance Brokers Ltd. 18008336700

    Uploaded by

    vansham malik
    64 views2 pages
    This document is a certificate of insurance and policy schedule for a private car liability only policy. It provides insurance coverage from July 24, 2021 to July 23, 2022 for Mr. Bhupesh Sardana's 2016 Maruti Celerio registered in Delhi. The policy covers liability for death, bodily injury, and property damage up to the amounts required by law. It also includes a personal accident coverage of Rs. 15 lakh for the owner-driver. The total premium due is Rs. 2,887.46.

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    Original Title

    VPTP184415000100

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    This document is a certificate of insurance and policy schedule for a private car liability only policy. It provides insurance coverage from July 24, 2021 to July 23, 2022 for Mr. Bhupesh Sardana's 2016 Maruti Celerio registered in Delhi. The policy covers liability for death, bodily injury, and property damage up to the amounts required by law. It also includes a personal accident coverage of Rs. 15 lakh for the owner-driver. The total premium due is Rs. 2,887.46.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    64 views2 pages

    Intermediary Code: Intermediary Name: Contact:: BR150000 Probus Insurance Brokers Ltd. 18008336700

    Uploaded by

    vansham malik
    This document is a certificate of insurance and policy schedule for a private car liability only policy. It provides insurance coverage from July 24, 2021 to July 23, 2022 for Mr. Bhupesh Sardana's 2016 Maruti Celerio registered in Delhi. The policy covers liability for death, bodily injury, and property damage up to the amounts required by law. It also includes a personal accident coverage of Rs. 15 lakh for the owner-driver. The total premium due is Rs. 2,887.46.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Service Branch Address: 108 / 109 & 111,1st floor, Ambadeep,14, K.G.

    Marg , Connaught Place, New Delhi,

    July 21, 2021

    MR. BHUPESH SARDANA


    A-2/34, PRATEEK APARTMENT Intermediary Code: BR150000
    BLOCK-A 2,PASCHIM VIHAR WEST Intermediary Name: PROBUS INSURANCE BROKERS
    NEW DELHI
    DELHI, DELHI LTD.
    110063
    Telephone :
    Contact: 18008336700
    Mobile No.: xxxxxx5499

    CERTIFICATE OF INSURANCE & POLICY SCHEDULE


    (See Form 51 of The Central Motor Vehicles Rules, 1989) Motor Vehicles Act, 1988
    Private Car Liability only Policy.
    Certificate of Insurance and Policy No. Policy Period: Period Of Insurance
    VPTP184415000100 From 18:58:32 hours on 24/07/2021 To 23:59:59 hours on 23/07/2022
    INSURED DETAILS
    Name of Insured Geographical Area Business/ Registration Authority Registration Date
    Profession

    MR. BHUPESH SARDANA INDIA BUSINESS / DELHI 05/04/2016


    SALES
    PROFESSION
    Registration Number DL-9-CAU-4426 Model Description CELERIO GREEN VXI CNG - 5 SEATER Gross Vehicle Weight (Kgs)
    Engine Number 7701111 Type of Body HATCHBACK Seating Capacity (including Driver) 5
    Chassis Number MA3ETDE1S00292617 Cubic Capacity 998
    Make of the Vehicle MARUTI UDYOG LTD. Year of Manufacture 2016 Total Premium (in Rs.) 2,887.46

    LIMITATIONS AS TO USE: DRIVER:


    The Policy covers use of the vehicle for any purpose other than: Any person including the Insured
    a) Hire or Reward, Provided that a person driving holds a valid Driving Licence at the time of the
    b) Carriage of goods (other than samples or personal luggage) accident and is not disqualified from holding or obtaining such a Licence.
    c) Organized racing Provided also that the person holding an effective Learner’s Licence may also
    d) Pace making drive the vehicle and that such a person satisfies the requirements of Rule 3 of
    e) Speed testing The Central Motor Vehicles Rules, 1989.
    f) Reliability Trials
    Any purpose in connection with Motor Trade.

    LIMITS OF LIABILITY:
    Under Section I-1 (i) of the Policy - Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988.
    Under Section I-1 (ii) of the Policy - Damage to Third Party Property –Rs.7,50,000- In respect of any one claim or series of claims arising out of one event/-
    Personal Accident cover for Owner - Driver under section III: CSI Rs. 15,00,000

    Nominee Name : MRS MANISHA Nominee Age : 46 Relationship with : SISTER


    Guardian Name : Guardian Age : Guardian Relation :
    LIABILITY
    1. Basic premium including premium for TPPD 2,072.00
    2. Less: For restricted TPPD cover for Rs.6000 (IMT 20) 0.00
    3. Trailers(IMT 30) 0.00
    4. Bi-Fuel Kit (CNG/LPG) @ 4% (IMT 25) 60.00
    ADD: Personal Accident Benefits
    5. Under section III (Owner Driver) CSI, Rs. 15,00,000.00* 315.00
    6. Geographical Area Extn.Endt.IMT-1 0.00
    7. Named Passengers, CSI Rs.0.00 each as per list attached (IMT
    15) 0.00
    8. Unnamed passengers, CSI 0.00 each (IMT16) 0.00
    Rs.
    9. PA Cover to Paid Driver, CSI Rs. 0.00 (IMT 17) 0.00
    ADD:Legal Liability
    10. Legal Liability To Paid Driver (IMT 28) 0.00
    11. Legal Liability To Employees (IMT 29) 0.00
    12. Add: SGST 220.23
    13. Add: CGST 220.23

    TOTAL LIABILITY PREMIUM 2,447.00 TOTAL PREMIUM 2,887.46

    In Witness whereof this Policy has been signed at Chennai on 24/07/2021 in lieu of Cover note No. dated Receipt No. IMC0720824. 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 the Motor Vehicles Act, 1988.

    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
    Signature OF
    of wider terms appearing in the Certificate in order to comply with the Motor Vehicles Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE NotCERTAIN
    TERMS AND RIGHT OF RECOVERY” under Policy Terms and Conditions. Verified
    For Royal Sundaram General Insurance
    Digitally signed by Co. Limited
    TAIKAD MAHADEVAN
    SHYAMSUNDER
    Date: 2021.07.21
    18:58:33 GMT+05:30
    Reason: For
    RoyalSundaram
    Location: Chennai

    Authorized Signatory
    This document is digitally signed, hence counter signature / stamp is not required.
    *CPA cover for owner driver will expire on 23/07/2022
    Consolidated Stamp Duty Paid to Govt. of Tamil Nadu
    For Legal interpretation, English version will hold good. GSTIN: 07AABCR7106G1ZL UIN: IRDAN102P0004V02201617 PAN Number: AABCR7106G

    Document Code:

    Point of Sales Person Name : Vandana Jajoo Contact Number : Mobile No.:
    Aadhaar Card Number : XXXX-XXXX-4519 PAN Number : AOOPJ4292F

    4faa7dc0cae0e0eb8538b76f3e5bf181
    GST Invoice

    Royal Sundaram General Insurance Co. Limited


    108 / 109 & 111,1st floor, Ambadeep
    14, K.G.Marg , Connaught Place, New Delhi,
    Delhi - UT - 110001
    GSTIN : 07AABCR7106G1ZL

    Policy number : VPTP184415000100


    Invoice Number : VPTP18441500000
    Inception Date : 24/07/2021 - 18:58:32
    Policy Posted Date : 21/07/2021 18:58:32

    Address of Insured:
    A-2/34, PRATEEK APARTMENT
    BLOCK-A 2,PASCHIM VIHAR WEST
    NEW DELHI
    NEWDELHI
    DELHI
    Pincode:110063

    Accounting code of service : 997134


    Description of service: Motor vehicle insurance services

    Taxable premium 2,447.00

    SGST 9% 220.23

    CGST 9% 220.23

    Gross premium 2,887.46

    Indication if tax payable under reverse charge - No

    Note: This document is digitally signed, hence counter signature / stamp is not required.

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