THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Commercial Vehicle Package Policy

UIN Number - IRDAN190RP0044V01100001

Policy Number :62060331200100091273

POLICY ISSUING OFFICE: BUSINESS CHANNEL: CLAIM CONTACT:
VIJAYAWADA BO (635471), NAME: DIRECT BUSINESS - (1D4022447) VIJAYAWADA BO (635471)
LIONS CLUB BUILDING , NEAR LOTOUS Mr. K.H M Kumar - (NIAAG00124707) LIONS CLUB BUILDING,NEAR LOTOUS FUNCTION
FUNCTION HALL , ANNAPURNA PHONE NUMBER: / / 9391014871 HALL,ANNAPURNA CINIMAHAL ROAD,
CINIMAHAL HOME ROAD,VIJAYAWADA, LAND/FAX NUMBER:/ VIJAYAWADA;0866245866/0866245877/94404548
ANDHRA PRADESH , 520001. EMAIL: / 79
PHONE NUMBER:0866245866 /
0866245877 / 9440454879
FAX NUMBER:NA / NA
Email:nia.635471@newindia.co.in

INSURED DETAILS
Insured's Name MULAGALA RAMBABU Customer ID PO896505(PAN
Insured's Address S/O SUBBARAO Contact Number No :NA)
4-30/1
SOCIETY ROAD,TANUKU
PYDIPARRU,TANUKU,WEST GODAVARI
ANDHRA PRADESH Email
534211 GSTIN NA

POLICY DETAILS
Period of cover 28/03/2023 12:00:01AMto 27/03/2024 11:59:59 PM Receipt Number 62060381200000167408-
28/03/23
Previous Insurer . Previous Policy Number 0000
VEHICLE DETAILS
Geographical Area / Zone: India/C Year of manufacture: 2018
Type of Commercial TRACTOR FOR COMMERCIAL USE Sub Type: AGRICULTURE
Vehicles: TRACTOR
MBNAS48ABJTM32676
Name of the Financier: NA Chassis no./Engine no.: RJG2KGA5420

Type of fuel: DIESEL Cubic capacity ( cc): 2731

Type of body: OPEN Gross Vehicle Weight 2630
(GVW):
Make/Model: MAHINDRA & MAHINDRA LIMITED Registration no. AP-37-TJ-2661
Seating capacity including 5 Variant: SWARAJ 843 XM
Driver:
Automobile Association none Colour: BLUE
membership:
Cover Note No/Cover / Name of registration RTA BHIMAVARAM
Note Issue Date: authority:

INSURED DECLARED VALUE (Rs)

Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
0 0 0 0 NA

SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 0 Basic TP Premium 8450
(+)Compulsory PA Premium for Owner Driver(Sum 250
Insured Rs 1500000)
(+)LL to paid driver conductor cleaner employed for 100
oprn
Calculated OD Premium Calculated TP Premium 8800
0
Total OD Premium (Rs) 0 Total TP Premium (Rs) 8800

Policy No. :62060331200100091273 Document generated by AG_0091688 at 2023/03/28 11:26:38.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
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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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Net Premium (Rs) 8800

GST (Rs) 1584
Total Payable (Rs) 10384
Total Payable in Rs(in words): RUPEES TEN THOUSAND THREE HUNDRED AND EIGHTY FOUR ONLY

GSTIN(Issuing Office) 37AAACN4165C2ZP

SAC 997139 (Other non-life insurance services excl RI)
Limitation as to use:The Policy covers use only under a permit within the meaning of the Motor Vehicles Act, 1988 or such a carriage falling
under Sub-section 3 of Section 66 of the Motor Vehicles Act, 1988.The Policy does not cover use FOR a)Organised racing b) Pace Making c)
Reliability Trials d) Speed Testing
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 7,50,000
For individual covers (OD) in RS;NA Compulsory excess in Rs:NA
Imposed excess in Rs:0 Voluntary excess in Rs:0
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
NA NA NA NA NA
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
NA NA NA NA
Premium and GST Details
Rate of Tax Amount in INR
Rs 1584
Premium
792
SGST 9
CGST 9 792
IGST 0 0
Premium Rs28056
SGST 6 1230
CGST 6 1230
IGST 0 0

In witness where of this policy has been signed at VIJAYAWADA BO on this 28/03/2023
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.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company website.
I/We hereby certify that the policy to which this Certificate For and on behalf of The New India Assurance Company Limited
relates as well as this Certificate of Insurance are issued in
accordance with the provisions of Chapter X and XI of M.V. Act,

Policy No. :62060331200100091273 Document generated by AG_0091688 at 2023/03/28 11:26:38.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
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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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

1988.
Date of Issue: 28/03/2023

(Mr. P. K. THIRAPATHI RAO)

[A.O. (D)]

Duly Constituted Attorney(s)

Tax Invoice No : 62060381200000167408

IRDA Registration Number: 190

Policy No. :62060331200100091273 Document generated by AG_0091688 at 2023/03/28 11:26:38.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
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.
Página 3 de 3

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