This Document is Digitally Signed
The Oriental Insurance Company Limited Signer: AJIT KUMAR
Date: Tuesday, October 29, 2019 2:20 PM
Location: NOIDA
MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE
MOTORISED-TWO WHEELERS PACKAGE POLICY - ZONE B
Policy No : 480200/31/2020/4786 Prev Policy No : 480200/31/2019/3446
Cover Note No : - Cover Note Dt :
Insured's Code : 82731308 Issue Office Code : 480200
Insured's Name : MR.K.RAJAGOPAL (GSTIN: Issue Office Name : DO TUTICORIN (GSTIN:
33BAKPR8583C1ZE) 33AAACT0627R3Z4)
Address : S/O KASI Address : NO 6-A, FIRST FLOOR
NO:1A/4D,SUNDARAVELPURAM 1st AVM BUILDING ,NORTH COTTON ROAD
STREET WEST
TUTICORIN-628008
TUTICORIN 628008 TUTICORIN TAMIL NADU 628001
Tel /Fax /Email : / / 9585675858 / Tel /Fax /Email : 0461- 2326899 / 2326877 / /
welcomesuzuki2009@gmail.com s.rajendra@orientalinsurance.co.in
Lead/Breakin No : /
Agent/Broker Details
Dev.Off.Code : NA0000001718 J.MUTHUMANICKAM
Agent/Broker :
Address :
Tel /Fax /Email : ////
Period of Insurance : FROM 00:00 ON 13/11/2019 TO MIDNIGHT OF 12/11/2020
Collection No & Dt : CC 1032303399 - 29/10/2019 GST INVOICE NO :331810523705 UIN :0
Gross Premium : 1,460 GST : 262 Stamp Duty : .5 Total : 1,722
Geographical Area : INDIA Area Extension :
Particulars of Insured Vehicle:
Registration Mark Engine No. & Year Of Type Of Body Seating Capacity Cubic
& Place Chassis No. Manufacture (including Driver) Capacity
Make - Model Type Of Fuel
TN-69-BD-9388 AF211469648 - SUZUKI INDIA-SUZUKI 2017 SOLO 1+1 125
MB8DP11AKH860 ACCESS UZ 125
6569 PETROL
Limitations 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.
1 Use only for social, domestic and pleasure purposes and for the insured's business or profession. The Policy does not cover use for
hire or reward, tuition, racing, pace making, reliability trial, speed testing, carriage of goods(other than samples or personal luggage)
in connection with any trade or business or use for any purpose in connection with Motor Trade
Driver: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 requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limit of Liability:Under Section II-I(i) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-I(ii) in respect of any one claim or series of claims arising out of one event is Rs. 100000
P.A. Cover under Section III for Registered Owner Cum Driver (CSI) : Rs. 1500000
*This Insurance excludes all pre-existing damages
Insured's Declared Value
Non Electrical Electrical
For the Vehicle For the Side Car Accessories Accessories Value of LPG/CNG Total Value
43,424 0 0 0 0 43,424
Place : TUTICORIN
Date : 29/10/2019
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This Document is Digitally Signed
The Oriental Insurance Company Limited Signer: AJIT KUMAR
Date: Tuesday, October 29, 2019 2:20 PM
Location: NOIDA
Attached to and forming part of policy number 480200/31/2020/4786
SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
BASIC OD COVER 727.79 BASIC TP COVER 752.00
LESS :Underwriter's Discount 437.00 BASIC TP TOTAL 752.00
MOTOR OD BASIC - NEW 290.79 ADD :PA FOR OWNER DRIVER-GR36A 360.00
BASIC OD TOTAL 290.79 TP TOTAL 1,112.00
ADD :ADD-ON COVER NIL DEPRECIATION 182.00 TOTAL PREMIUM 1,460.00
POLICY
LESS :NIL DEPRECIATION POLICY 9.00 ADD :SGST 131.00
RENEWALl DISCOUNT
ADD :CGST 131.00
OD TOTAL 464.00
STAMP DUTY 0.50
LESS :NO CLAIM BONUS-GR27 115.95
MOTOR TOTAL OD 348.00 TOTAL AMOUNT 1,722.00
* NCB discount - 25 %
Deductibles under Section-I : COMPULSORY DEDUCTIBLE Rs.100
Subject to IMT Endorsement Printed herein/attached to : IMT-22 , OIC-1:Nil Depreciation Cover
Details of IMT Endorsements are also available on the Company¿s Web Portal www.orientalinsurance.org.in
Hypothecation Agreement with: -
Hire Purchase/Lessor Agreement with: -
In the event of a claim under the policy exceeding Rs.1lac or a claim for refund of premium exceeding Rs1lac,the insured will comply with
the provisions of the AML policy of the Company.The AML policy is available in all our operating Offices as well as company's website.
The insurance under this policy is subject to conditions, clauses, warranties, exclusions, IMTs and OIC endorsements mentioned
herein above which are available on Company's website: www.orientalinsurance.org.in or on demand from the policy issuing office
Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void
abinitio (from inception).
Claim is not admissible if Driving Licence is found fake or is not valid whether or not in the knowledge of the insured.
I/We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the
provision of Chapter X and Chapter XI of Motor Vehicles Act, 1988.
In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at TUTICORIN
on 29-OCT-19
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 MVAct, 1988 is
recoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".
Entered By : welcomesuzuki2009@gmail.com For and on behalf of
The Oriental Insurance Company Limited
Policy Printed By : PRTL
AJIT KUMAR
Policy Printed On : 29-OCT-19 14:20:29 General Manager
Authorised Signatory
This is an electronically generated document (Policy Schedule). The Policy document duly stamped will be sent by post.
In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485.
CIN: U66010DL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees
IRDA Regn. No. 556 - Now you can buy and renew selected policies online at www.orientalinsurance.org.in
Place : TUTICORIN
Date : 29/10/2019
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