IRDAI REGN. NO.
- 137
SHRIRAM GENERAL INSURANCE COMPANY LIMITED
E-8,EPIP,SITAPURA INDUSTRIAL AREA,JAIPUR,
RAJASTHAN-302022
CONTACT(TOLL FREE): 1800 – 30030000, 1800 – 1033009
CERTIFICATE CUM POLICY SCHEDULE
POS - GOODS CARRYING MOTORISED THREE WHEELERS AND MOTORISED PEDAL CYCLES-PUBLIC CARRIERS - Zone B
MOTOR COMMERCIAL VEHICLE (PACKAGE POLICY) -
UIN No.IRDAN137RP0018V01200809 - SAC Code: 997134
Issue Office 418007-Address-E-8,Sitapura,Jaipur Issue Office Phone No. 7847957766 / 67 / 68 / 69 / 70
...............POLICY SERVICING OFFICE : 302,,
1st Floor, 41, A.J. Chambers,, BANGALORE,
KARNATAKA - 560004
CIN NO.U66010RJ2006PLC029979
Geographical Area INDIA Policy No. 418007/31/23/008946
Insured's Code/ Name IN-26177846 / MR. HARISHA R GSTIN No. Of Insured Unregistered
Insured Address NO 34 & 35,3RD CROSS BANASAVADI M GARDEN,NEAR WATER TANK, B S PALYA, BANGALORE
, BANASWADI
, BANGALORE, KARNATAKA
- 560043
Insured State Code 29 NCB Discount (%) 0
Executive Mr.ASWATHAREDDY N - NA0000006265 Period of Insurance From 21:32 Hrs of 18/07/2024 To
Midnight Of 18/07/2025
Agent Details ARUN KUMAR - PSN000004000- Mobile No.-
7019458328
PAN No. AEQPA0615R
Prop No. - TR No. N.A - N.A Prop Issue Date N.A
Gross Premium 8439 IGST 0
CGST 625 SGST/UTGST 625
Previous Insurer N.A. Total 9689
Previous Policy No. N.A Nominee for RAJA N
Owner/Driver
Nominee Age 58 Nominee Relationship Father
Appointee Name N.A Appointee Relationship N.A
REGISTRATI ENGINE NO. & CHASSIS NO. MAKE - MODEL TYPE OF BODY CUBIC G.V.W DATE OF REGN. / SEAT CAP.
ON MARK & / FUEL TYPE CAPACI DELIVERY (INCL. DRIVER)
PLACE TY/
YEAR OF
MANF.
NEW & TXTCSBZ3008270 & PIAGGIO - APE XTRA PICKUP / CNG 300 / 975 14/09/2022 0+1
BANGALORE MBX0008LB1C164386 HT LDX PLUS BS 6 2022
SOUTH
Battery Number Motor Number
IDV FOR THE IDV FOR TRAILER
NON ELECTRICAL ELECTRICAL CNG/LPG kit SI TOTAL VALUE
VEHICLE ACCESSORIES ACCESSORIES
283179.00 0 0 0 0 283179.00
Own Damage Policy Period Liability Policy Period
From Date & Time 18/07/2024 To Date & Time 18/07/2025 23:59 From Date & Time 18/07/2024 To Date & Time 18/07/2025 23:59
21:32 Hrs Hrs of Midnight 21:32 Hrs Hrs of Midnight
SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
OD TOTAL 3522.00 BASIC TP COVER 4492.00
TOTAL PREMIUM 8439.00 ADD :InBuilt CNG Cover 60.00
ADD : SGST/UTGST 9.00% 355.00 ADD :GR36A-PA FOR OWNER DRIVER 315.00
ADD : CGST 9.00% 355.00 ADD :Legal Liability Coverages For Paid Driver 50.00
ADD : SGST/UTGST 6.00% 270.00 TP TOTAL 4917.00
ADD : CGST 6.00% 270.00
PREMIUM AMOUNT 9689.00
The above Total OD Premium is inclusive of all applicable Loading/Discounts viz ( Automobile Association, Voluntary Excess, Anti-Theft, Handicap Person,
Driver Tuition, Fibre Glass,CNG/LPG Unit, Geographical Extn, Imported Vehicle etc. wherever applicable ). PA Owner Driver CoverPeriod:- From 21:29
Hrs of 18/07/2024 To Midnight of 18/07/2025
ADD-ONS:- Motor Protection(IRDAN137RP0018V01200809/A0008V01202223)
CPA Policy number: , CPA Sum Insured: 0.00, CPA Company Name: , CPA Valid From: N.A., CPA Valid To: N.A.
Deductibles under Section-I : Compulsory Deductible Rs.500
Subject to IMT Endorsement Printed herein/attached to : IMT-23, IMT-25, IMT-28, IMT-40, IMT-7, IMT-21.
Hypothecation Agreement with: MAHI & MAHI FINANCIAL SERVICES LTD
Hire Purchase/Lease Agreement with:
Limit of Liability :
Under Section II-1(i) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-1(ii) in respect of any one claim or series of claims arising out of one event is Rs. 750000
P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 1500000
PreInspection Survey: Dented Part : N.A,Broken Part : N.A, Scratched Part : N.A ,Claim not payable for : N.A
Preinspection Report: Not Applicable
PLACE : BANGALORE -
For and on behalf of
JAYANAGAR
Shriram General Insurance Co.Ltd.
We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the
expiry date of your policy. If you do not want us to contact you, kindly send an e-mail for the same on
dnd@shriramgi.com
For Policy Wordings, NEFT/RTGS/IMPS or any other online payment kindly visit our website
"www.shriramgi.com".
All the Amounts mentioned in this policy are in Indian Rupees Note :- Claim intimation after 48 hours will be
GSTIN No. 29AAKCS2509K1ZZ considered as delayed intimation.
Authorized Signatory
Page 1 of 2
IRDAI REGN. NO. - 137
SHRIRAM GENERAL INSURANCE COMPANY LIMITED
E-8,EPIP,SITAPURA INDUSTRIAL AREA,JAIPUR,
RAJASTHAN-302022
CONTACT(TOLL FREE): 1800 – 30030000, 1800 – 1033009
CERTIFICATE CUM POLICY SCHEDULE
POS - GOODS CARRYING MOTORISED THREE WHEELERS AND MOTORISED PEDAL CYCLES-PUBLIC CARRIERS - Zone B
MOTOR COMMERCIAL VEHICLE (PACKAGE POLICY) -
UIN No.IRDAN137RP0018V01200809 - SAC Code: 997134
Attached to and forming part of policy number : 418007/31/23/008946
Driver's Clause
Any person including 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 when not used for the
transport of goods at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limitations as to Use:
Use Only For Carriage Of Goods Within The Meaning Of The Motor Vehicles Act. The Policy Does Not Cover: 1) Use For Organised Racing, Pace-Making,
Reliability Trial Or Speed Testing. (2) Use Whilst Drawing A Trailer Except The Towing (Other Than For Reward) Of Any One Disabled Mechanically
Propelled Vehicle. (3) Use For Carrying Passengers In The Vehicles; Except Employees (Other Than The Driver) Not Exceeding The Number Permitted In
The Registration Document And Coming Under The Purview Of Workmen'S Compensation Act 1923.
The Policy covers use only under a permit within the meaning of the Motor Vehicle Act, 1988 or such a carriage falling under Sub-section 3 of Section 66
of the Motor Vehicle's Act 1988 The insurance under this policy is subject to conditions, clauses, warranties, endorsements as per forms
attached.Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and thepolicy shall be void abinitio
(from inception). 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 BANGALORE - JAYANAGAR
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".
POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.
If policy is cancelled/Endorsed beyond the said date [i.e.30/09/2023],only the proportionate amount of premium would be refunded and any GST amount would
NOT be refunded owing to the restrictions prescribed under GST law.
Note: In case of new vehicle, Insured have to submit registration documents within a period of 15 days from the date of issue of Registration Certificate of Vehicle.
In case of Claims/Grievance, Please contact us at: Toll Free No – 180030030000, 18001033009 Email id - chd@shriramgi.com
For instant renewal of your insurance policy, Log on to www.shriramgi.com or contact us at our Head office no. - 0141-4828400
PLACE : BANGALORE -
For and on behalf of
JAYANAGAR
Shriram General Insurance Co.Ltd.
We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the
expiry date of your policy. If you do not want us to contact you, kindly send an e-mail for the same on
dnd@shriramgi.com
For Policy Wordings, NEFT/RTGS/IMPS or any other online payment kindly visit our website
"www.shriramgi.com".
All the Amounts mentioned in this policy are in Indian Rupees Note :- Claim intimation after 48 hours will be
GSTIN No. 29AAKCS2509K1ZZ considered as delayed intimation.
Authorized Signatory
Page 2 of 2
