Reliance General Insurance Company Limited.

Servicing Office : 7th Floor Surya Tower The Mall Ludhiana , , , LUDHIANA, PUNJAB (State Code:03) -141001
5HOLDQFH3ULYDWH&DU3DFNDJH3ROLF\ UIN --IRDAN103RP0010V02100001
Certificate Cum Policy Schedule (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
PAN :AABCR6747B GSTIN: 03AABCR6747B1ZQ CIN :U66603MH2000PLC128300 IRDAI Reg:103

Policy No: 996092323110027259 Proposal No. & Date: HIIB5837022, 20-NOV-2023

Policy Issued On: 20-NOV-2023 16:11 HRS Previous Policy No.: 3001/HI-11816580/00/000
Insured Name: MR. GAGANDEEP SINGH Previous Insurer: ICICI Lombard General Insurance Company Limited.
Period of Own Damage : 26-NOV-2023 (00:00) To 25-NOV-2024 (1 YEAR)
VILL- RASULPUR, TEH - BASSI PATHANA, , FATEHGARH SAHIB , Period of Liability Cover: 26-NOV-2023 (00:00) To 25-NOV-2024 (1 YEAR)
Insured Address:
PUNJAB (State Code:03) -140412
Period of Compulsory 26-NOV-2023 (00:00) To 25-NOV-2024 (1 YEAR)
Personal Accident Cover:
Customer Type PAN GSTIN Name Age (Yr.) Relation
Customer Details Nominee Details
INDIVIDUAL XXXXX7944C NA AKWINDER KAUR 35 SPOUSE

Vehicle Details
Make Model Variant Cubic Capacity Manufacturing Year Seating capacity
HYUNDAI I20 MAGNA (O) 1.4 DSL BSIV 1396 2012 5
Body Type Registration No. RTO Hypothecation/Lease* Fuel Type VIN/Chassis No.
HATCHBACK PB 23 N 0808 FATEHGARH SAHIB NO DIESEL MALBB51RLCM489447
Vehicle IDV Electrical Accessories Non-Electrical Accessories BI Fuel Kit Total IDV Engine No
220,000 0 0 0 220,000 D4FCCU208297

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

Basic Own Damage Premium Basic Third Party Liability Premium 3,416
Vehicle 3,773 Bi-Fuel Kit 0
Non-Elec. Accessories (IMT-24) 0 Geographical Area Extension (IMT-1) 0
Elec. Accessories (IMT-24) 0 Sub Total (Third Party Liability) 3,416
Bi-Fuel Kit (IMT-25) 0 Personal Accident (PA) Cover
Geographical Area Extension (IMT-1) 0 Compulsory PA Cover for Owner Driver Rs 1500000 (IMT-15) 475
IMT 23 Premium 0 PA Cover for 0 Unnamed Passengers Rs 0 Each (IMT-16) 0
Sub Total (Basic Premium) 3,773 PA cover for Paid Driver of Rs 2 Lac (IMT-17) 0
Discount/Deductibles Sub Total PA Cover 475
Voluntary Deductibles (0) (IMT-22A) 0 Legal Liability
Anti Theft Device (IMT-10) 95 Paid Driver (IMT-28) 50
AA Membership (IMT-8) 0 Employees (for 0 persons) (IMT-29) 0

No Claim Bonus (50%) 1,839 Sub Total (Legal Liability) 50

Handicapped Discount (IMT-12) 0 Net Liability Premium (B) 3,941

Sub Total (Deductibles) 1,934 Total Premium (A+B) 5,780
Total Own Damage Premium 1,839 SGST(9%) 521
Add On Coverages 0 CGST(9%) 521
Net Own Damage Premium (A) 1,839 Gross Premium Paid 6,822
Add-on Cover Opted in the Policy:

Notes: 1. Consolidated Stamp duty Paid vide Letter of Authorization ³NO.LOA/CSD/78/2023/(Validity Period Dt.01/07/2023 to Dt.01/01/2024)/3029 DT.26 JUN ´at General Stamp Office, Mumbai. ** Not
Applicable
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: India
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.reliancegeneral.co.in
*Hypothecation Details: 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.reliancegeneral.co.in/Insurance/About-Us/Grievance-Redressal.aspx 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 : PUNJAB(State Code : 03), Insurer Invoice Number : HAP/Y112023234110
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. Scan for Renewal For & On Behalf of
Corporate Office:16th Floor, Building No. 9A, DLF Cybercity, Phase III, Gurugram, (Valid from 90 Days Prior to Expiry) Reliance General Insurance Company Limited.
Haryana 122001
Broker Code: 822 (Valid UPTO:30/05/2025) MISP NAME-RACHHPAL AUTO ALLIANCE
CIN No.: U67200HR2021PTC098982 PRIVATE LIMITED
GST: 06AAGCH0310P1ZP MISP CODE-HIIB-MHY-0051
Email ID: connect@hiib.in DP NAME-HARPREET SINGH
Contact No: 0124-6833000
Authorized Signatory
For Claims, Policy Servicing & Renewal, Kindly contact (PAUL HYUNDAI) at +91-9814833471