Cholamandalam MS General Insurance Co. Ltd.

Servicing Office : 4 Mary Gold, Shanajaf Road, , LUCKNOW, UTTAR PRADESH (State Code:09) -226001
Motor Private Car Package Policy UIN --IRDAN123RP0001V03100001
Certificate Cum Policy Schedule (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
PAN :AABCC6633K GSTIN: 09AABCC6633K7ZB CIN :U66030TN2001PLC047977 IRDAI Reg:123

Policy No: 3311/01857127/000/00 Proposal No. & Date: HIIB13075391, 28-DEC-2024 Cancelled
Policy Issued On: 28-DEC-2024 18:44 HRS Previous Policy No.: D130222154
Insured Name: MR. RAMOO YADAV Previous Insurer: Go Digit General Insurance Ltd.
Period of Own Damage : 01-JAN-2025 (00:00) To 31-DEC-2025 (1 YEAR)
VILLAGE NAYA GAON NOIDA , GAUTAM BUDH NAGAR , UTTAR Period of Liability Cover: 01-JAN-2025 (00:00) To 31-DEC-2025 (1 YEAR)
Insured Address:
PRADESH (State Code:09) -201305
Period of Compulsory 01-JAN-2025 (00:00) To 31-DEC-2025 (1 YEAR)
Personal Accident Cover:
Customer Type PAN GSTIN Name Age (Yr.) Relation
Customer Details Nominee Details
INDIVIDUAL XXXXX3748D NA SONAM 25 SPOUSE

Vehicle Details
Make Model Variant Cubic Capacity Manufacturing Year Seating capacity
HYUNDAI AURA 1.2MT CNG SX 1197 2023 5
Body Type Registration No. RTO Hypothecation/Lease* Fuel Type VIN/Chassis No.
SALOON UP 16 MT 0591 GAUTAM BUDH NAGAR YES PETROL+CNG MALB341CLPM237956
Vehicle IDV Electrical Accessories Non-Electrical Accessories BI Fuel Kit Total IDV Engine No
800,000 0 0 0 800,000 G4LAPM744740

Own Damage Premium (A) Amount(INR) Liability Premium (B) Amount(INR)

Basic Own Damage Premium Basic Third Party Liability Premium 3,416
Vehicle 11,488 Bi-Fuel Kit 60
Non-Elec. Accessories (IMT-24) 0 Geographical Area Extension (IMT-1) 0
Elec. Accessories (IMT-24) 0 Sub Total (Third Party Liability) 3,476
Bi-Fuel Kit (IMT-25) 574 Personal Accident (PA) Cover
Geographical Area Extension (IMT-1) 0 Compulsory PA Cover for Owner Driver Rs 1500000 (IMT-15) 450
IMT 23 Premium 0 PA Cover for 0 Unnamed Passengers Rs 0 Each (IMT-16) 0
Sub Total (Basic Premium) 12,062 PA cover for Paid Driver of Rs 2 Lac (IMT-17) 0
Discount/Deductibles Sub Total PA Cover 450
Voluntary Deductibles (0) (IMT-22A) 0 Legal Liability
Anti Theft Device (IMT-10) 288 Paid Driver (IMT-28) 0
AA Membership (IMT-8) 0 Employees (for 0 persons) (IMT-29) 0

No Claim Bonus (0%) 0 Sub Total (Legal Liability) 0

Handicapped Discount (IMT-12) 0 Net Liability Premium (B) 3,926

Sub Total (Deductibles) 288 Total Premium (A+B) 20,558
Total Own Damage Premium 11,774 SGST(9%) 1,851
Add On Coverages ( ZD,CM,KP,PB ) 4858 CGST(9%) 1851
Net Own Damage Premium (A) 16,632 Gross Premium Paid 24,260
Add-on Cover Opted in the Policy: Waiver of depreciation(IRDAN123RP0001V01200203/A0003V02200910), Consumables Plus Cover(IRDAN123RP0001V01200203/A0007V01201617), Loss of
Key Cover(IRDAN123RP0001V01200203/A0006V01201617), Loss of Laptop and Mobile phone(IRDAN123RP0001V02100001/A0008V01202021)
Notes: 1. Consolidated Stamp Duty Paid Vide G.O. Rt No.157,Commercial Taxes and Registration (j1) Department, Tamil Nadu dated 28/04/2021
2.This policy has been issued upon declaration by the Insured that a valid Pollution Under Control (PUC) Certificate is held on the date of
commencement of the Policy. The insured undertakes to renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, 3.Geographical Area Ext. extended to (IMT-1): NA
during the subsistence of the Policy.
5.The policy is subject to compulsory deductible of INR 1000
4. Policy issuance is subject to realization of cheque if premium is paid by cheque (IMT-22) & Voluntary Deductible of INR 0
6. This policy is to be read in conjunction with the Policy /Add-on wordings T&C available on the insurer website
http://www.cholainsurance.com

*Hypothecation Details: KOTAK MAHINDRA BANK LTD - noida - noida Payment Mode: Online
Limitations as to use:The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4) Pace
making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver's Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such
license. Provided also that the person holding an effective learners license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet the requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii) of
the policy-Damage to third party property is INR 7.5 Lakhs, PA Cover Under Section III for Owner-Driver is INR 15 Lakhs.
No Claim Bonus: 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) - 20%, preceding
two consecutive years - 25%, preceding three consecutive years - 35%, preceding four consecutive years - 45%, preceding five consecutive years - 50% of NCB on OD Premium.
NCB is allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
Declaration on Tax Invoice 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.
Important Notice: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with the schedule. Any payment made by the company by reasons 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 & RIGHT
OF RECOVERY" For legal interruption, English version will hold good.
Grievance Clause: For resolution of any query or grievance, Insured may check Grievance redressal policy at https://www.cholainsurance.com/customer-grievance or connect with the respective servicing
office of insurance company. In the event of unsatisfactory response,he/she may approach the insurance ombudsman for the redressal of grievance at www.irdai.gov.in or on website of General Insurance
Council: www.gicouncil.in
HSN/SAC : 997134, Description of Service : Motor Vehicle Insurance Services, Place of Supply : UTTAR PRADESH(State Code : 09), Insurer Invoice Number : HY00899799
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 XI of Motor Vehicle Act, 1988.
Insurance Broker Name : Hyundai India Insurance Broking Pvt. Ltd. For & On Behalf of
Corporate Office:16th Floor, Building No. 9A, DLF Cybercity, Phase III, Gurugram, Scan for Renewal Cholamandalam MS General Insurance Co. Ltd.
Haryana 122001 (Valid from 90 Days Prior to
Expiry)

Broker Code: 822 (Valid UPTO:30/05/2025) MISP NAME-ASHVAR CARS INDIA

CIN No.: U67200HR2021PTC098982 PRIVATE LIMITED
GST: 06AAGCH0310P1ZP MISP CODE-HIIB-MHY-0228
Email ID: connect@hiib.in DP NAME-TUSHAR AGGARWAL
Contact No: 0124-6833000
Authorized Signatory
For Claims, Policy Servicing & Renewal, Kindly contact (ASHVAR CARS INDIA PRIVATE LIMITED) at +91-7042493313