Issuing Office Name & Address
CHHINDWARA BRANCH , PANKAJ PLAZA, FIRST FLOOR, NEAR ELC
SQUARE, NAGPUR ROAD, CHHINDWARA, MADHYA PRADESH, PIN :
480001
Tel: 07162 247188 Fax:
GSTIN No: 23AAACN9967E1ZB
National Insurance Company Ltd.
Registered & Head Office: 3, MIDDLETON STREET, POST BOX NO. 9229, KOLKATA - 700 071
CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE
Form 51 of the Central Motor Vehicle Rules, 1989
Policy No: 32070631206760003076 1 Year Liability Only from 18:47 Hrs of 07/10/2022 to Midnight of 06/10/2023 IXI
Insured Details
Name : Mr SHASHANK AGRAWAL
Address : S/O. SHRI MOHAN AGRAWAL - APSARA DRESSES, SEONI, DISTT - SEONI, M.P. , MADHYA PRADESH , SEONI
Pincode : 480661 Telephone : 8319720435 Email : agrawalshashank1701@gmail.com
PAN No. : GSTIN No. : Aadhar No. :
Channel : PRADEEP BANGAR Mobile : 9425175756 Email : pradip.bfs@gmail.com
Aadhar : PAN : xxxxxx499D Code. : 320706 / 9000159397
Vehicle Details
Make & Model Two Wheeler Yamaha FZ 250 FZ25
Reg. No. Engine No. Chassis No. Type of Body CC Mfg. Year Seat Cap. Reg. District
MP-22-ML-5145 G3H7E0021234 ME1RG4216H0021225 249 2019 1+1 SEONI
Geographical Area : INDIA.
Vehicle IDV Non Elec Access. Elec Access. Bi-fuel kit Trailer Total IDV
- - - - - -
OD Premium Breakup in Rs. TP Premium Breakup in Rs.
Basic OD Premium Basic TP Premium 1,193.00
(+) Geographical Area Extension - (+) Geographical Area Extension -
(-) Vol. Excess Discount - (+) WC for Driver YES 50.00
(-) Auto. Assoc Discount - (+) PA to owner driver -
(-) Anti-theft Discount - (+) PA to unnamed PAX -
(-) Other Discount - (-) Discount For Limited TPPD -
(-) NCB Discount TP Total (Rounded Off) 1,243.00
(+) Nil Depreciation - OD Total (Rounded Off)
(+) Nil Depreciation Plus - TOTAL PREMIUM 1,243.00
(+) NCB Protect - GST 224.00
(+) Engine Protect - NET PAYABLE 1,467.00
(+) Invoice Protect - Collection Number :32070681208000004747 dated 07-Oct-2021
OD Total (Rounded Off) Subject to IMT Endorsement No. 24,25,28
Excess : Compulsory: Rs. 0 Imposed: Rs. 0 Voluntary: Rs. 0
Limitation as to use : The Policy covers use of the Vehicle for any purpose other than (a) Hire or Reward (b) Carriage of 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
Drivers Clause : Any person including Insured Provided that a person driving holds an effective driving licence at the time of the 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
Vehicles Rules, 1989.
Limits of Liability Clause: Under section 1(i) Such amount as is necessary to meet the requirements of the motor vehicle act 1988.
Under section 1(ii) Damage to third party property is Upto Rs. 1,00,000 .
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 reasons 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.
Financier : SELF OWNED
Prev Policy : Not Available
Nominee Name : Relation : Age :
NOTE : Warranted that in case of dishonour of the premium cheque, this document stands automatically cancelled 'AB-INITIO'.
Policy stamp to be defaced at the respective policy servicing office.
I/We hereby certify that this Certificate cum Schedule of Insurance is issued in accordance with the provisions of chapter X and chapter XI of Motor Vehicles Act,1988.
Authorised Signatory
For & On behalf of
National Insurance Company Limited
NIC/UBPORTAL/9000159397 07/10/2022 06:47 PM
Visit us at https://nationalinsurance.nic.co.in for information on Products, Services and Grievance Redressal.
Customer Care Toll Free Number: 1800 345 0330 Email: customer.support@nic.co.in
