https://

MA Go Digit General Insurance Ltd.

Schedule/Receipt
Digit Two-Wheeler Liability Only Policy
UIN No.: IRDAN158RP0003V01201718

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Name PANKAJ KISHOR Vehicle Registration No. JH17E1404
Address AT+PO+PS-MAHESHPUR,DIST- RELIASSURE INSURANCE BROKERS
Partner Name
PAKUR,PAKUR PRIVATE LIMITED
JHARKHAND,GODDA,JHARKHAND,816106, 1118607
Partner Code
Pakur-816106
Mobile xxxxxxxxx0249 Partner Mobile No. 9899992811 PB
Email na@na.com Partner Email saurabh.bhatnagar@reliassure.in
Aadhar No. 7187 For Claims, contact us at 1800-258-5956

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YOUR POLICY DETAILS

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1 Policy No. D110188027 / 26072023 Policy Issue Date Invoice No. IA102748715

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27-Jul-2023 17:57:30

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From
Period of Policy Policy Term 1 Year

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To 26-Jul-2024 23:59:59
IGS

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From --
Invoice 26-Jul-2023
Period of Policy for PA Owner Driver

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PB To -- Date

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YOUR VEHICLE DETAILS

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RTO location Godda,JHARKHAND Make BAJAJ Model/Vehicle

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PULSAR/ELECTRIC START
Variant (Sub-
STD

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Engine No. DHZCCC08075 Chassis No. MD2A11CZ9CCC08766 Type)

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MAK
G01 Body Type Motor Cycle Fuel Type Petrol Year of Regn 2012
128.5

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Seating

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2
Capacity Cubic Capacity 150 CC Year of Mfg. --

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FASTag Financier
Odometer D
Number Details
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ENDORSEMENT
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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium
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20

IA102748715 2023-07-26 714.00 128.52 0.00 0.00 0.00 0.00 842.52

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M LIABILITY PREMIUM (`)

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IGS 714.00 PA cover for Owner-Driver (`)

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OE Basic Third-Party Liability (`) --

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FH PA cover for 2 unamed passengers each 0 (`) -- PA cover for Paid Driver 0 (`) --
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Legal Liability to Employees (`) -- Legal Liability to Paid Driver (`) --

MAK Net Premium (`) 714.00
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IGST @ 18% = (`128.52) 128.52

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Final Premium (`) 842.52

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OTHER DETAILS
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Previous Insurer -- Previous Policy No. --

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Previous Policy
IMT - Endorsements -- Expiry Date --
17

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xt GSTIN/UIN No. Unregistered State Code 20
JH

Receipt No. RA115170888 Receipt Date 26-Jul-2023

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Nominee Details
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Other Detials --
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Geographical Area: Any liability incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and
endorsed. Limitation as to use: The policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial,
speed testing and use for any purpose in connection with the Motor Trade. Person or Class of persons entitled to drive: Any person including the
insured. 1) Provided that a person driving holds a valid effective driving license at the time of the accident and is not disqualified from holding or
obtaining such a license. 2) Provided also that the person holding a valid effective Learner’s License may also drive the vehicle and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and any subsequent amendment as applicable. Limits of
http Liability: 1) 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
Vehicles Act, 1988 and any subsequent amendment as applicable. 2) Under Section II - 1 (ii) of the policy: Damage to Third Party Property - (`
100000) 3) P.A. Cover for Owner Driver under Section III (CSI) -(`)(per annum).

Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095.IRDAI Reg
No. 158 CIN U66010PN2016PLC167410, GST Reg. No.: 07AACCO4128Q1Z2 HSN: 997134/General Insurance Services, GSTIN Address: Delhi Business
Centre,5th Floor, B Wing, IFCI Tower, 61, Nehru Place,New Delhi,Delhi,PIN-110019
https://

MA Go Digit General Insurance Ltd.

Schedule/Receipt
Digit Two-Wheeler Liability Only Policy
UIN No.: IRDAN158RP0003V01201718

PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of
your declaration that you do not hold a valid Driving License on or before the date of commencement of this Policy / already have an
alternate Personal Accident insurance cover of Rs. 15 Lakhs
Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.

PUC Declaration:The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before
the date of commencement of the Policy .Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in
case of dishonor of Cheque or non-receipt of payment. Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of
Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages
under the Policy. 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 Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from
the insured. See the Clause headed (Avoidance Of Certain Terms And Right Of Recovery) in the policy. This policy is subject to the standard

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policy wordings, warranties and conditions applicable for this product in addition to coverages and exclusions specified in the motor vehicle tariff
published by IRDAI. Policy would be void on the ground that it was obtained by non- disclosure of material fact or by a representation of fact

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Note: The policy is issued in utmost good faith, relying on the information shared by insured at the time of obtaining the policy. The terms and

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conditions detailed in this policy schedule as well as the policy document sent by Digit shall prevail in case of any dispute.

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For & On Behalf of Go Digit General Insurance Ltd.

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In case of claim or any other query, please

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contact our 24-hour Call Centre at 1800-

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258-5956 or email us at hello@godigit.com Praveen Bhat
Senior Vice President – Customer Experience

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or visit our website www.godigit.com. praveen.bhat@godigit.com
Authorized Signatory

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Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty has been paid as per Letter of

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Authorization No.67-B/04/2017-18 Date: 30th May 2017
issued by Department of Stamps and Registration ,

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Bengaluru- 560009 - KARNATAKA.

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Hey, our document is now digitally signed

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Click here to view the certificate.
D For instant resolution, you can ping us “Hi”
on WhatsApp at 702 606 1234
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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095.IRDAI Reg
No. 158 CIN U66010PN2016PLC167410, GST Reg. No.: 07AACCO4128Q1Z2 HSN: 997134/General Insurance Services, GSTIN Address: Delhi Business
Centre,5th Floor, B Wing, IFCI Tower, 61, Nehru Place,New Delhi,Delhi,PIN-110019