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 :5453537003124010000

POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
SIRSA (353700), NAME: DIRECT BUSINESS - (1D7836098) Rohtak Non Suit Claim Hub (359005)
SIRSA , , , Mr. Akash . - (NIAAG00119135), ADDRESS: 313, DELHI ROAD, MODEL TOWN,
HARYANA , 125055. PHONE NUMBER: / 9729804946 / 9729804946 ROHTAK, 124001 , , , HARYANA , 124001.
PHONE NUMBER:01666222017 LAND/FAX NUMBER:/ PHONE NUMBER: 123456 /
FAX NUMBER:NA / NA EMAIL: / akashguglani493@gmail.com MOBILE NUMBER:
Email:nia.353700@newindia.co.in Email: ch359005@newindia.co.in

INSURED DETAILS
Insured's Name Balwinder Singh Customer ID PO91D028458 (PAN No
:CTMPS2934N)
Insured's Address S/O MOHINDER SINGH PATTI BHULERIA Contact Number XXXXXX2600
VPO GOBINDPURA
BHATINDA ,PUNJAB, 151001
Email vermapolicy5@gmail.com

GSTIN NA

POLICY DETAILS
Period of cover 21/08/2024 12:00:01 AM to 20/08/2025 11:59:59 PM Receipt Number 10000089240800602488 -
20/08/24
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 35670131230100001000
VEHICLE DETAILS
Geographical Area / Zone: Bangladesh,Bhutan,Nepal,Pakistan,Sri Year of manufacture: 2012
Lanka,Maldives,India/C
Type of Commercial A - Goods Carrying Sub Type: Truck -
Vehicles: Public Carrier
Name of the Financier: Chassis no./Engine no.: F10912/2894190
Type of fuel: Diesel Cubic capacity ( CC): 0
Type of body: Open Gross Vehicle Weight 15500
(GVW):
Make/Model: ASHOK LEYLAND- AL 1212 Registration no. PB-03-BB-0681
Seating capacity including 3 Variant: 9 M TRAILER W/SIDE WALL
Driver: ON LPS4018TC BS3
Automobile Association none Colour: NP
membership:
Cover Note No/Cover / Name of registration Bhatinda
Note Issue Date: authority:
FASTag ID:

INSURED DECLARED VALUE (Rs)

Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel/CNG/LPG kit Total Value
0 0 0 0 0

SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 0 Basic TP Premium 35313
(-)Calculated NCB Discount(50%) 0 (+)Compulsory PA Premium for Owner Driver(Sum 100
(+)Loading for Extension of Geographical area 0 Insured Rs 1500000) 50
(+)Loading for Inclusion of IMT 23 0 (+)Extension of Geographical Area Premium 0
Signature Not
Verified
Digitally signed
by DHIRAJ Policy No. : 35370031240100002595Document generated by QR_RENEWAL at 2024/08/20 17:27:57.
KUMAR
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2024.08.20
17:27:58 IST 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 1 de 3

Page 1 of 3
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

(+) Additional OD Premium for Bi-Fuel/CNG/LPG 0

(+)LL to paid driver conductor cleaner employed for 50
oprn
Calculated OD Premium 0 Calculated TP Premium 35513
Total OD Premium (Rs) 0 Total TP Premium (Rs) 35513
Net Premium (Rs) 35513
GST (Rs) 4237
Total Payable (Rs) 39787.00
Total Payable in Rs(in words): RUPEES FIFTY-TWO THOUSAND THREE HUNDRED FIFTY-ONE ONLY
GSTIN(Issuing Office) 06AAACN4165C2ZU
SAC 997134 (Motor vehicle insurance services)
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:738000 Compulsory excess in Rs:1500
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

PA cover for named persons

Name CSI Opted(Rs.) Nominee Relationship

Premium and GST Details

Rate of Tax Amount in INR

Premium 0
SGST 0 0
CGST 0 0
IGST 0 0
Premium 0
SGST 0 0
CGST 0 0
IGST 0 0

In witness where of this policy has been signed at SIRSA on this 20/08/2024
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 1,21,23,40.
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.

Policy No. : 35370031240100002595Document generated by QR_RENEWAL at 2024/08/20 17:27:57.

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 2 de 3

Page 2 of 3
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

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,
1988.
Date of Issue: 20/08/2024

(Mr. SORABH SINGLA)

[Sr. D.M.]

Duly Constituted Attorney(s)

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

Tax Invoice No : 35370024P0003630

IRDA Registration Number: 190

NIA PAN NUMBER: BAACN4165C

Policy No. : 35370031240100002595Document generated by QR_RENEWAL at 2024/08/20 17:27:57.

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

Page 3 of 3