Royal Sundaram General Insurance Co.

Limited
(Formerly known as Royal Sundaram Alliance Insurance Company Limited)
Corporate Office:Vishranti Melaram Towers,
No.2/319,RajivGandhiSalai(OMR),Karapakkam,Chennai–600
097.
Service Branch Address:
Lakshmi Commercial Complex,605-606,6th Floor,Senapato Bapat Marg,Dadar(West),M9-Dadar ,MUMBAI - 400028.

Oct 26, 2024

Oct 26, 2024

M/s.RADAJI GLASS
NO 314 MAHESH INDUSTRIAL
NEXT
PREMISE MIRA BHAYANDER RENEWALISON
ROADBHAYNDAR ROAD MIRA ROAD
THANE,MAHARASHTRA 02/10/2025
401107
Telephone :
Mobile: 99xxxxxx27

Certificate of Insurance and Policy Policy Period:Period of insurance

No.VGT0489906000100 From 00:00 hours on 03/10/2024 To Midnight of 02/10/2025

Dear Customer,
Thank you for choosing Royal Sundaram as the Insurer of your vehicle. We are delighted to have you as our customer.Please find
enclosedGoods Carrying Vehicle Policy No. VGC1123348000100 which has been issued based on the details mentioned below:
Name of the Insured:M/s.RADAJI GLASS
Mobile No.:99xxxxxx27 Email ID:Yog******@gmail.com
Make of the Vehicle:EICHER Model Description:Pro 2114XP S G HSD 17FT
Engine No.:E426CDNH404976 Chassis No.:MC2ESGRC0NH212815
Premium Amount (Rs.)58,995.28 Add-on Covers Opted :No
This policy is issued after pre-inspection on . Any Pre-existing damages observed during the pre-inspection is not covered
inthis policy.
Previous Policy No. 6320954255/00/00
Previous Policy Insurance Co. TATA AIG GENERAL INSURANCE COMPANY LTD.
Based On your declaration on No claim being made in expiring policy, we have extended next slab of no claim discount
inyour policy(0 %)
Does the vehicle have valid Pollution Under Control (PUC) Certificate: Yes
Pollution Certificate Number (PUC) :
PUC expiry date :
*In line with the Central Motor Vehicle Act, 1989 and as per the directive of Hon'ble Supreme Court of India, it is mandated that insured
mustproduce a valid "Pollution Under control" Certificate as and when asked by the insurer and it is the responsibility of the insured to renew
thesame before expiry of the validity of the PUC certificate. Absence of Valid certificate may lead to cancellation of insurance
CPA Status
Opted – Coverage Sum Insured :1,500,000
The policy is processed based on the information declared by you. While the information regarding the vehicle,
insured(yourselves),detailofcoversandterms/conditionscouldbeascertainedfromtheCertificateofInsuranceandPolicySchedule
(Enclosed), some of the very critical ones like No Claim Bonus extended, KYC Details, status of CompulsoryPersonal Accident
(CPA) Cover and details regarding Vehicle Inspection if any etc. are furnished above.
Coverage of risk is subject to realization of the full premium, post which, insurance coverage under the policy
wouldcommence. In-case the premium is not received by us due to cheque dishonor or any other reason or
misrepresentation ofany information, the insurance cover shall be void ab-initio.
Please check all the information printed in these pages for its correctness and should there be a discrepancy, reach
us(Contact details provided below) for suitable rectification. In case there is no response within 15 days of policy inception, it
willbe deemed that all information provided are correct and all future transactions would be based on such information only.
The above information is to be read in conjunction with the policy certificate of issuance and policy schedule and shall
beconsidered null and void without the same.
To read the “policy” & “add on” terms, conditions, exceptions and applicable endorsement, please log on to ourwebsite
www.royalsundaram.in. Should you have any queries, please contact our Customer Service helpline number1860-425-
0000,1860-258-0000. You may also write to customer.services@royalsundaram.in

Assuring you of our best services at all

times.Yours sincerely,

Authorized Signatory
6e58c4854a2424232e70060fbd0cc01b
Note: To download the claim form and to know more about Royal Sundaram products please log on to www.royalsundaram.in
Registered Office: 21, Patullos Road, Chennai - 600002 | IRDAI Reg. No.102 | CIN:
U67200TN2000PLC045611CustomerCare18604250000,18602580000|Email:customer.services@royalsundaram.in|Visit:
 Royal Sundaram General Insurance Co. Limited
(Formerly known as Royal Sundaram Alliance Insurance Company Limited)
Corporate Office:Vishranti Melaram Towers, No.2/319,Rajiv
Gandhi Salai (OMR), Karapakkam, Chennai –
600097.RegisteredOffice:21 ,Patullos Road, Chennai - 600
002

Service Branch Address:

Lakshmi Commercial Complex,605-606,6th Floor,Senapato Bapat Marg,Dadar(West),M9-Dadar ,MUMBAI - 400028.

Mar 12, 2024

M/s.RADAJI GLASS
Intermediary BR501315
NO 314 MAHESH INDUSTRIAL Code:Interm
PREMISE MIRA BHAYANDER
ROADBHAYNDAR ROAD MIRA ROAD ediaryName: Greenlife
THANE,MAHARASHTRA
401107
InsuranceBorking
Telephone : Pvt. Ltd
Mobile: 99xxxxxx27

Contact: -

CERTIFICATE OF INSURANCE& POLICY SCHEDULE

(See Form 51 of The Central Motor Vehicles Rules, 1989) Motor Vehicles Act, 1988
Goods Carrying Vehicle Policy
Certificate of Insurance and Policy Policy Period:Period of insurance
No.VGT0489906000100 From 00:00 hours on 03/10/2024 To Midnight of 02/10/2025
INSURED DETAILS
Insured Geographical Registration Registration
Name of Insured Business/Profession
Dateof Area Authority Date
Birth

M/s. RADAJI GLASS 21/02/2022 India VASAI 12/10/2022

INSURED'S DECLARED VALUE (IDV) (in Rs.)

For the For Value of Total
Non Electrical Accessories Electrical / Electronic Accessories
Vehicle Trailers CNG Kit IDV
24,00,000 0 0 0 0 24,00,000

VEHICLE DETAILS
Registration Number MH04LE3098 Type of Body Open
Engine Number E426CDNH404976 Public Carrier/Private Carrier Public Carrier

Chassis Number MC2ESGRC0NH212815 Year of Manufacture 2022

Make of the Vehicle EICHER MOTORS Gross Vehicle Weight (Kgs) 16,140

Model Description Pro 2114XP S G HSD 17FT Total Premium (in Rs.) 58,995.28
LIMITATIONS AS TO USE: As per Motor Vehicles Rules, 1989 Persons or Classes of Persons entitled to Drive:
The Policy covers use only under a Permit within the meaning of Any person including the Insured
theMotor Vehicles Act, 1988 or such a carriage falling under Sub- • Provided that a person driving holds an effective driving licence
section 3of Section 66 of the Motor Vehicles Act, 1988. atthe time of the accident and is not disqualified from holding
The Policy does not cover use for orobtaining such a License.
a) Organised racing b) Pace Making c) Speed testing • Provided also that the person holding an effective learner's license
d) Reliability Trials may also drive the vehicle when not used for the transport of goods
atthe time of the accident and that such a person satisfies
therequirements of Rule 3 of The Central Motor Vehicles Rules 1989.
LIMITS OF LIABILITY:
UnderSectionII-1(i)ofthePolicy-Deathoforbodilyinjury-SuchamountasisnecessarytomeettherequirementsoftheMotorVehiclesAct,1988.
UnderSectionII-1(ii)ofthePolicy-DamagetoThirdPartyProperty-Rs750000(asperIMT20)-Inrespectofanyoneclaimorseriesofclaimsarising out of one event.
Personal Accident cover for Owner - Driver under section IV: CSI - Rs.1,500,000/-

Note: Warranted that at no time the gross laden weight of the vehicle exceeds the gross vehicle weight mentioned in the schedule of the policy.
Deductible under Section -I : Rs. 500/-(Compulsory Deductible [Rs.500] and Imposed Deductible [Rs. 0])

Document Code:

6e58c4854a2424232e70060fbd0cc01b

You can reach us through the details given below Mon - Sat 8.00am to 9.00pm and Sunday up to 5.00pm
Call:1860 425 0000,1860 258 0000 SMS:type <MOTORCLAIMS> and send to 567675

E-Mail:customer.services@royalsundaram.in www.royalsundaram.in
 Royal Sundaram General Insurance Co. Limited
(Formerly known as Royal Sundaram Alliance Insurance Company Limited)
Corporate Office:Vishranti Melaram Towers, No.2/319,Rajiv
Gandhi Salai (OMR), Karapakkam, Chennai –
600097.RegisteredOffice:21 ,Patullos Road, Chennai - 600
002

CERTIFICATE OF INSURANCE& POLICY SCHEDULE(CONTINUED)

(See Form 51 of The Central Motor Vehicles Rules, 1989) Motor Vehicles Act, 1988
Goods Carrying Vehicle Policy
Policy No. VGC1123348000100
Premium Premium
A - OWN DAMAGE B - LIABILITY
inRs. inRs.
1.a) Basic premium on Vehicle 3462.96 1. Basic premium including premium for TPPD 35,313.00
b) Non-Electrical Accessories 0.00 2. Reduction in TPPD to Rs.6000/- 0.00
2. Additional GVW over 12,000 Kgs 0.00 3. Trailers Endt. IMT-30 0.00
3. Electrical & Electronic Accessories @ 4% (IMT 24) 0.00 4. Bi – Fuel Kit (CNG/LPG) IMT-25 0.00
4. Bi-Fuel Kit (CNG/LPG) @ 4% (IMT 25) 0.00
ADD: ADD::
5. Trailer 0.00 Personal Accident Benefits
6. Overturning Risk 0.00 5. Geographical Area Extn. Endt.IMT-1 0.00
7. Geographical Area Extn.Endt.IMT-1 0.00 6. Under Section IV- Rs.1,500,000/- 315.00
8. Cover for Lamps, Bumpers, etc. Endt. IMT – 23 4516.47 7. PA to Paid Driver/ Cleaners Endt. IMT-17 0.00
9. Fibre Glass Tanks 50.00 8. EnhancedPA cover , Owner Driver, CSI Rs.0 0.00
9. Enhanced PA cover, Paid Driver, CSI 0.00
10. Additional Towing Charges. Rs.0 0.00 Rs.0.00Legal Liability:
11. 60% on OD Premium for Driving Tuition 0.00 10. To Paid Driver/Cleaner(not exceeding 7
12. Usage of Commercial and Private Purpose - IMT 34 0.00 persons)Endt. IMT-28 100.00
LESS: 11. ToPaidDriver/Cleaner/Coolies(exceeding7persons)E
0.00
ndt. IMT-39A
13. 50% Discount for vehicles specially 12. To Coolies Endt. IMT-39 0.00
designed/modifiedfor blind, handicapped and 0.00
mentally challengedpersons 13. NFPP - Employees Endt. IMT-37 0.00
14. Discount for Anti-theft Devices Endt. IMT-10 0.00 14. NFPP Other than Employees Endt. IMT-37A 0.00
15. Discount for vehicles plying within insured own premises 0.00 15. Usage of Commercial and Private Purpose - IMT 34 0.00
16. 0% NCB 0.00 16. TOTAL LIABILITY PREMIUM (B) 35,728.00
17. ADD:Discount moderation 0.00 17. ADD: Underwriting Loading% 0.0
18. Confined to own sites 0
19. Total Premium (A+B) 0.0
0
49,996.00
Add: Additional Cover for Package Policies
18. DepreciationWaiver Clause(IRDAN102A0001V01201011) 6240.00 ADD:SGST 4,499.64
19. WindshieldGlass(IRDAN102A0002V01201011) 0.00 ADD:CGST 4,499.64
20. EMI Protector Clause
0.00
(IRDAN102A0003V01202021)Limit. Rs.0.00
21. LossofIncomeCover(IRDAN102A0005V01202021)Li
0.00
mit in Rs.0.00 Duration: 0 months
22. TOTAL OWN DAMAGE PREMIUM (A) 14,268.00 22. TOTAL PREMIUM PAYABLE 58,995.28
No Claim Bonus:
a) No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous year. b) 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 preceding year(s), as per the details given below:

Subject to IMT Endt. Nos. & memorandum 23,28,21 (refer Terms & Conditions
Period of Insurance % of NCB on OD Premium
forrelevant wording)
Under Hire Purchase/Lease Agreement /Hypothecated with
The preceding year 20
Nominee Name Nominee Age Relationship with
Preceding two consecutive years 25
0
Preceding three consecutive years 35 Guardian Name Guardian Age Guardian Relation
0
Preceding four consecutive years 45
Date and Signature of Proposal/Renewal notice 12/03/2024
Preceding five consecutive years 50

In Witness whereof this Policy has been signed at Chennai on 12/03/2024 in lieu of Cover note No. dated Receipt No. CBCEAP1369318. I/We hereby certify that the Policy
towhich 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
byreason 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
"AVOIDANCEOF CERTAIN TERMS AND RIGHT OF RECOVERY" under Policy Terms and Conditions.

For Royal Sundaram General Insurance Co. Limited

SignatureNotVerified
Digitally signed by
TAIKADMAHADEVANSHYAMSUND
ERDate:2024.03.1220:09:38IST
Reason:ForRoyalSundaram
Consolidated Stamp Duty Paid to Govt of TamilNadu Location:Chennai
Authorised Signatory

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

GSTIN : 27AABCR7106G1ZJ Base Product UIN: IRDAN102P0005V02201617

Enhanced PA Cover Clause UIN:
A0017V01201920For Legal interpretation, English version will hold good.

You can reach us through the details given below Mon - Sat 8.00am to 9.00pm and Sunday up to 5.00pm
Call:1860 425 0000,1860 258 0000 SMS:type <MOTORCLAIMS> and send to 567675

E-Mail:customer.services@royalsundaram.in www.royalsundaram.in
 Royal Sundaram General Insurance Co. Limited
(Formerly known as Royal Sundaram Alliance Insurance Company Limited)
Corporate Office:Vishranti Melaram Towers, No.2/319,Rajiv
Gandhi Salai (OMR), Karapakkam, Chennai –
600097.RegisteredOffice:21 ,Patullos Road, Chennai - 600
002

GST Invoice
Royal Sundaram General Insurance Co.
LimitedMR:M9-Dadar
Address: Lakshmi Commercial Complex,605-606,6th Floor,Senapato Bapat Marg,Dadar(West),M9-Dadar ,MUMBAI -
400028.GSTIN: 27AABCR7106G1ZJ

Policy Number : VGT0489906000100

GST Invoice Number : VGT048990600000
Invoice Date : 30/09/2024

Address of insured:
Insured Name: M/s.RADAJI GLASS
GND GALA NO 314 MAHESH
INDUSTRIAL PREMISE MIRA
BHYENDAR ROAD MIRA ROAD EAST
THANE
State:MAHARASHTRA
Pincode: 401107
GSTIN : 27BFFPJ3522R1Z2

HSN Taxable CGST SGST/UTGST IGST Total

SAC Value Rate Amount Rate Amount Rate Amount Amount

997134 14,268 9.00% 1,284.12 9.00% 1,284.12 2,568.24

9971 35,728.00 6.00% 2,143.68 6.00% 2,143.68 4,287.36

Indication if tax payable under reverse charge - No

“I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than
theaggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of
thesaid sub-rule.”:

Note:“Thisdocument is digitally signed”

“This document is electronically generated.This document should be issued along with the Policy document.This document
standsinvalid,if issued separately”

You can reach us through the details given below Mon - Sat 8.00am to 9.00pm and Sunday up to 5.00pm
Call:1860 425 0000,1860 258 0000 SMS:type <MOTORCLAIMS> and send to 567675

E-Mail:customer.services@royalsundaram.in www.royalsundaram.in