UNITED INDIA INSURANCE COMPANY LIMITED

LIC BUILDING,JEEVAN NIDHI-II GROUND FLOOR,AMBEDKAR CIRCLE B.S.ROAD,JAIPUR

JAIPUR - 302005 RAJASTHAN
PH: (141) 2744222,(141) 2744976 FAX: EMAIL:

TWO WHEELER-1 YEAR OWN DAMAGE COVER BUNDLED WITH 5 YEARS LIABILITY
COVER
UIN: IRDAN545RP0011V01201819
POLICY NO.:1413003124P110815356
VEHICLE NO.:NEW

PERIOD OF INSURANCE
Own Damage:From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2025
Liability:From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2029

Insured
MR DHARU SINGH
GRAM DHATURIYA TEHSIL ALOTE RATLAM MP
457114
RATLAM
MADHYA PRADESH
CONTACT NUMBER: 9669993389 (M)
IMPORTANT NOTICE: KINDLY UPDATE YOUR AADHAAR NO. AND PAN/FORM 60. PLEASE IGNORE IF ALREADY UPDATED.

TURTLEMINT INSURANCE BROKING

Agent Name :
SERVICES PVT LTD_452
Agent Code : BRC4520796
9513312901 / (1800) 2660101
Mobile/Landline Number/Email :
support@turtlemint.com

The genuineness of the policy can be verified through "Verify Your Policy" link at www.uiic.co.in.

For any Information, Service Requests, Claim intimation and Grievances please write to 141300@uiic.co.in

Download Customer App(www.uiic.co.in). REGD. & HEAD OFFICE, 24, WHITES ROAD, CHENNAI - 600014.
Website: http://www.uiic.co.in
Printed By : CUSTOMER @ 18/10/2024 6:52:40 PM

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 UNITED INDIA INSURANCE COMPANY LIMITED
CERTIFICATE OF INSURANCE
TWO WHEELER-1 YEAR OWN DAMAGE COVER BUNDLED WITH 5 YEARS LIABILITY COVER
UIN: IRDAN545RP0011V01201819
(FORM 51 OF CENTRAL MOTOR VEHICLE RULES 1989)
Policy No. 1413003124P110815356 Certificate Number 1413003124P110815356
Customer Id 23353935441 Issuing Office Address Code 141300
Name of the Insured MR DHARU SINGH LIC BUILDING,JEEVAN NIDHI-II
GRAM DHATURIYA TEHSIL ALOTE RATLAM MP GROUND FLOOR,AMBEDKAR CIRCLE B.S.ROAD,JAIPUR
302005
Address of the Insured 457114 JAIPUR
RATLAM RAJASTHAN
MADHYA PRADESH Telephone (141) 2744222,(141) 2744976
Business/Occupation Others Mobile No.- 9669993389
Insured's Declared Value 87249
Own Damage From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2025
Period of Insurance
Liability From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2029
Particulars of Vehicle Insured
Seating
Obsolete Year of Type of Cubic
Registration No. Engine No. Chassis No. Make/ Model including
Vehicle Mfg Body Capacity/KW
driver
HONDA MOTORCYCLE & TWO
JC94EG2211298 ME4JC944KRG112871
NEW No SCOOTER INDIA PVT 2024 WHEELER 125 2
LTD / SP 125 DISC
Registration Authority Geographical Area Financier Name Branch Agreement Type

MP43 RATLAM INDIA AU SMALL FINANCE BANK LTD.. RATLAM Hypothecation

Amount in words: Four thousand seven hundred seventy-three rupees only

Persons or classes of persons entitled to drive
Any person including Insured provided that a person holds an effective driving licence at the time of accident and is not disqualified from
holding or obtaining such a licence. Provided also that the person holding an effective Learner's Licence may also drive the vehicle and
such a person satisfies the requirements of Rule 3 of Central Motor Vehicle Rule, 1989.
Note:- The policy does not cover liability for death, bodily injury or damage as excluded insection 150 (2) (ii) and (iii); (b) and (c) of the
Motor Vehicles Act, 1988.
Limitations as to use Premium: 4,045.00
IGST(18%): 728.00
The policy covers use of the vehicle for any purpose other than Stamp Duty: 1.00
a) Hire or Reward Total(Rounded off): 4,773.00
b) Carriage Goods (other than samples or personal luggage) Receipt Number : 10114130024112333010
c) Organized Racing Receipt Date: 18/10/2024
d) Pace Making
DebitNote Number:
e) Speed Testing and Reliability Trials
f) Use in connection with Motor Trade Document Date:
Limits of Liability Agency/Broker Code: BRC4520796
Under Section II-I (i) Death or bodily injury in respect of any one TURTLEMINT INSURANCE
accident; As per Motor Vehicles Act 1988 BROKING SERVICES PVT
LTD_452
Direct Business:
Under Section II-I (ii) Damage to third party property in respect of
any one claim or series of claims arising out of one event: 6000 Dev Officer :
/-
Subject to IMT Endorsement No.s, terms and conditions printed herein / attached hereto 7,20,22
I/We hereby certify that the policy to which the certificate relates as well as For and On behalf of
the certificate of insurance are issued in accordance with provisions of United India Insurance Co. Ltd.
Chapter X & XI of M.V Act, 1988.
Date of Issue: 18/10/2024

Duly Constituted Attorney

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 PolicyNo.: 1413003124P110815356

TWO WHEELER-1 YEAR OWN DAMAGE COVER BUNDLED WITH 5 YEARS LIABILITY COVER
UIN: IRDAN545RP0011V01201819
SCHEDULE
Policy No. 1413003124P110815356 Previous Policy No.
Customer Id 23353935441
Name MR DHARU SINGH
Insured Details Tel (O): Tel (R) Fax:
Email: arpitgoyal787@yahoo.com Mobile: 9669993389
Business / Occupation Others
Own Damage From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2025
Period of Insurance
Liability From 12:05 Hrs of 18/10/2024 To Midnight of 17/10/2029
Co-Insurance Type

Particulars of Vehicle Insured

Seating
Obsolete Year of Type of Cubic
Registration No. Engine No. Chassis No. Make/ Model including
Vehicle Mfg Body Capacity/KW
Side Car
HONDA MOTORCYCLE & TWO
JC94EG2211298 ME4JC944KRG112871
NEW No SCOOTER INDIA PVT 2024 WHEELER 125 2
LTD / SP 125 DISC
Insured's Declared Value
Electrical/Electronic Total
For Vehicle For Side Car Non Electrical Accessories CNG Unit LPG Unit
Accessories Value

88249
87249 0 1000 0 0 0
Registration Authority Auto Association Membership No. Geographical Area Extension
MP43 RATLAM INDIA
Persons or classes of persons entitled to drive
Any person including Insured provided that a person holds an effective driving licence at the time of accident and is not disqualified from
holding or obtaining such a licence. Provided also that the person holding an effective Learner's Licence may also drive the vehicle and
such a person satisfies the requirements of Rule 3 of Central Motor Vehicle Rule, 1989.
Limitations as to use
The policy covers use of the Vehicle for any purpose other than:
a) Hire or Reward
b) Carriage Goods (other than samples or personal luggage)
c) Organized Racing
d) Pace Making
e) Speed Testing and Reliability Trials
f) Use in connection with Motor Trade
Limits of Liability As narrated in the Certificate of Insurance attached herewith.
EXCLUSIONS :
1) Any accidental loss or damage or Liability / caused or sustained or incurrred outside the geographical area.
2) Any claim arising out of any contractual liability.
3) Any accidental loss or damage to any property whatsoever or any loss or any expense whatsoever resulting or arising there from or any
consequential loss.
4) Any liability of whatsoever nature directly or indirectly caused by or constituted to or by or arising out of ionizing radiations or
contamination by radioactivity from any nuclear fuel. For the purpose of this exception, combustion shall include any self-sustaining
process of nuclear fission.
5) Any accidental loss or damage or liability directly or indirectly caused by or contributed to, by or arising from nuclear weapons material.
6) Any accidental loss, damage or liability directly or indirectly or proximatley or remotely occasioned by contributed to, by or traceable to
or arising out of or in connection with war, invasion, act of foreign enemies, hostilities or warlike operations (whether before or after
declaration of war), civil war, mutiny, rebellion, military or usurped power, or by any direct or indirect consequence of any of the said
occurrences or may consequence thereof and in default of such proof, the Company shall not be liable to make any payment in respect of
such a claim.
This policy is subject to terms and conditions and IMT Endorsement Nos. printed herein / attached hereto 7,20,22
Imposed Excess 0
Voluntary Excess 0 Financier Name Branch Agreement Type
Compulsory Excess 100 AU SMALL FINANCE BANK LTD.. RATLAM Hypothecation

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 PolicyNo.: 1413003124P110815356
SCHEDULE OF PREMIUM (IN )
OWN DAMAGE LIABILITY
(From 18/10/2024 To 17/10/2025) (From 18/10/2024 To 17/10/2029)

Basic premium on Vehicle and Accessories

B. Basic TP 3,851.00
A. Basic OD 292.46
Restricted TPPD Cover - 250.00
Non Electrical Accessories 3.35
Total 3,601.00
Total 295.81

Add :
Gross TP(B) 3,601.00
Nil Depreciation Without Excess 147.91
Gross OD & TP:
4,045.00
Sub Total (Additions) 147.91 (A) + (B)

Gross OD(A) 444.00

AMOUNT IN WORDS: Four thousand seven hundred seventy-three rupees only

TERMS AND CONDITIONS

AS PER THE INDIAN MOTOR TARIFF. PERSONAL COPY OF THE SAME IS AVAILABLE FREE OF COST ON REQUEST. FURTHER, THE INDIAN
MOTOR TARIFF IS ALSO AVAILABLE AND DISPLAYED AT ALL UNITED INDIA INSURANCE COMPANY OFFICES AND ON UIIC WEBSITE :
www.uiic.co.in
DISCLAIMER : THE POLICY STANDS CANCELLED OR VOID IN THE EVENT OF CHEQUE DISHONOR. THE COMPANY MAY CANCEL THE POLICY BY
SENDING 7 DAYS NOTICE IN CASE OF ANY FRAUD OR MISREPRESENTATION, NON-DISCLOSURE OF MATERIAL FACT OR NON-CO-OPERATION
OF THE INSURED.

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 THE CLAUSE HEADED "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF
RECOVERY". FOR LEGAL INTERPRETATION, ENGLISH VERSION WILL HOLD GOOD.

Agency/Broker Code: BRC4520796

TURTLEMINT
Premium: 4,045.00 Receipt Number : 10114130024112333010 INSURANCE BROKING
SERVICES PVT
LTD_452
IGST(18%): 728.00Receipt Date : 18/10/2024Direct Business:
Development Officer
Stamp Duty: 1.00 DebitNote Number :
Code:
Total (Rounded Off): 4,773.00 Document Date :

Customer GST/UIN No.: Office GST No.: 08AAACU5552C1ZJ

SAC Code: 997134 Invoice No. & Date: 3124I110815356 & 18/10/2024
Amount Subject to Reverse Charges-NIL

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.
Note:-With reference to IRDAI circular no IRDAI/NL/CIR/MOTP/170/10/2018 dated 09/10/2018 and as per the declaration given in
the proposal form by owner driver Compulsory Personal Accident (CPA) cover is removed, since he/she is not holding a valid driving
license.

Anti Money Laundering Clause:-In the event of a claim under the policy exceeding 1 lakh or a claim for refund of premium exceeding
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's web site.

LET US JOIN THE FIGHT AGAINST CORRUPTION. PLEASE TAKE THE PLEDGE AT https://pledge.cvc.nic.in.

Date of Proposal and Declaration: 18/10/2024

IN WITNESS WHEREOF, this policy has been signed at DO 3 JAIPUR 141300 on this 18th day of October 2024.

For and On behalf of

United India Insurance Co. Ltd.

Affix Policy
Stamp here.

Duly Constituted Attorney:

Underwritten By - TURLTD00436 ( BROKER )

This is a system generated document and any manual alteration / correction / overwriting in the document will make it invalid.

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