Long Term Two Wheeler Bundled Policy
Policy No. Issued at HERO INSURANCE BROKING INDIA PVT LTD.
39010231236200107100 NATIONAL INSURANCE COMPANY LIMITED IRDA Registration No.: 649
SCOPE Minar, Core 3, 2nd Floor, Laxmi Nagar, Delhi- 110 Toll-Free No.: 1800 102 4376
092. 264, Okhla Ind. Estate, Phase-III, Delhi-110020
Tel:011-23215595
nsureplus.64vb@nic.co.in
Insured Business/Profession Address of The Insured Period From Period To
23-12-2024 Midnight of 22-12-2029
SANDEEP KUMAR MAHICH Agriculture GODIYA BARA, SIKAR,, SIKAR-RAJASTHAN-332301 14:42:04
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg Cubic GSTIN No.
Capacity (Customer)
NEW HA11ECR4A16869 MBLHAW283R4A15090 HERO HF DELUXE 2024
100
Declared Value (IDV) of Side Car IDV Non-Electrical Electrical Accessories CNG/LPG/Bi- Total IDV
Vehicle Accessories IDV IDV Fuel IDV
64254.00 NA 0.00 0.00 0.00 64254
Place of Regn. Body Type HP/Lease/Hire-Purchase Branch Office of Seating Premium
Agreement With HP/Lease/Hire-Purchase Capacity
Sikar Solo --- 2 4620.00
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 431.00 Basic Third Party Liability : 3285.00
Non-Electrical-Fitting Premium : 0.00 TPPD Discount : 250.00
Electronic & Electrical Accessories : 0.00 Total : 3035.00
Bi-Fuel Kit : 0.00 CNG/LPG/Bi-Fuel Kit : 0.00
Geographical Extension : 0.00 Geographical Extension : 0.00
ND Plus Cover : 154.00 Add
Less : Compulsory PA Cover (Owner Driver) : 295.00
Handicapped Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Un Named Driver) : 0.00
NCB : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Total Own Damage Premium(A) : 585.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 3330.00
Total Premium (A + B) : 3915.00
For any other extra : 0.00
IGST @ 18.00% : 705.00
Gross Premium : 4620.00
1.RegistrationNo.:58||2.LicenceNo.:1424542||3.CNNNo.:U10200WB1906GOI001713|| GSTIN No.:07AAACN9967E1Z5 ||UIN No.-IRDAN058RP0005V01201819
Mapped Office Name & Address : NIC380500 -
23-12-2024 To 22-12- 23-12-2025 To 22-12- 23-12-2026 To 22-12- 23-12-2027 To 22-12- 23-12-2028 To 22-12-
OD Policy Period 2025 2026 2027 2028 2029
IDV 64254 NIL NIL NIL NIL
CPA Sum Insured Rs. 15 lakhs. NIL NIL NIL NIL
Sum Insured of Optional PA Cover:-Sum Insured of Optional PA Cover "Unnamed Passenger"-NA and "Unnamed Driver"-NA
LIMITATIONS AS TO USE:--The Policy covers use of the vehicle for any purpose other than: a) Carriage of goods (other than samples or personal luggage) b)
Organized Racing c) Pace Making d) Speed Testing e) Reliability Trials f) Any purpose in connection with Motor Trade.
DRIVER: 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 that such a person
satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act 1988. Limit of the
amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event : Upto Rs - 6000/
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 Vehicle Act, 1988 is recoverable from the insured. See the
clause headed 'AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY'
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with this provisions of Chapter X & XI of M.V. Act 1988
Broker : Hero Insurance Broking India Pvt. Ltd
Received Vide
Premium of Rs. 4620.00 Cash/Cheque No.
Dated Nominee Name
Drawn on Nominee Age 62 turn overleaf for details)
Consolidated Stamp Duty Paid Endorsements : IMT - 22,20,7
Acknowledgement 23-12-
2024 Nominee Relation Father
Policy Dt
FOR RENEWALS CONTACT: DHARNIA MOTORS Ph.No- 01531-220639
23-DEC-2024
Date & Signature of
proposer
Dealer's Stamp & Signature Duly Constituted Attorney
# : Received with Thanks Rs 4620.00 from Mr SANTU NATH S/O JAYRAM NATH as premium against the money receipt no 024231211474734
Regd. & Head Office : Premises No.18-0374, Plot No. CBD-81, New Town, Kolkata-700156 Service Tax Registration Number - AAACN996EST099
For further information about motor insurance policy please also visit www.irdai.gov.in >> Grievances >> Policyholder Handbooks
For information on Insurance Ombudsman you may visit website: https://www.cioins.co.in
