0 Product Code: 3001

UIN: IRDAN115RP0017V01200102
1 Ref. No.W414312586 Date: Apr 04, 2025

Insured Details Partner Details

Name Partner Name
PRITI SARDA RAKESH MALAK
Address Partner Code
W/O ABHISHEK SARDA, MAHAJANO KA MOHALLA, SADAR BAZAR, GACHHIPURA,
ITAWA BAMNIYA, ITAWALAKHA, NAGAUR, MAKRANA, RAJASTHAN, 341504,, POS15281
NAGAUR, RAJASTHAN - 341504
Mobile Number Partner Mobile Number:
80******49 9983313500
Policy No Partner Email:
3001/387970609/00/000

Hello PRITI SARDA, we have your car covered!

Here is your Private Car Package Policy

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Why go to our network garages?

Are you wondering why you should choose our partner garages to get your car repaired? We will help you make the decision easy, or else you'll miss out on the super
benefits that you get at our network garages!

Firstly, our partner garages offer cashless repairs. Which means you don't have to spend out of pocket. We directly settle your bill, and you can take possession of your car
once it's fixed. Some of the other great benefits that you receive at our partner garages include -

√ Pick up arrangement from your doorstep or accident spot

√ Quick vehicle survey through InstaSpect on our IL Take Care app
√ Service quality assurance for six months on repairs
√ Use of original parts in case of any replacement needed

All this comes at no added cost to you!

So the next time you need to make a car insurance claim, don't fret. Just give us a call or use our app to file the claim. Call us first, and we'll take care of everything!

For a convenient and cashless repairs you may visit any of our below mentioned network garages nearest to
your residence.

Garage Name Address Pin Code Contact No

DELUX CAR SERVICE CENTRE AJMER ROAD MERTA CITY 341504 9414004543
DELUX CAR
For complete list of network garages, download IL TakeCare app or WhatsApp ‘Hi’ on 773 8282 666 or visit
www.icicilombard.com

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 0 Product Code: 3001
UIN: IRDAN115RP0017V01200102
1

Dear PRITI SARDA,

Thank you for choosing ICICI Lombard General Insurance Company Limited to insure your vehicle. We are delighted to welcome you in the ever growing family of ICICI
Lombard. Please find enclosed Policy No. 3001/387970609/00/000.

We have taken care to include all the information provided by you in the policy document. Please read this section along with the "Important details" thoroughly.

Let us walk you through the features of your policy.

What’s covered?

Basic Covers

Add on covers

The chart below (including icons) illustrates the salient features of your policy in general and is for your easy
understanding. Please refer detailed policy document (schedule along with policy wordings) for coverage, benefits,
exclusions and terms & conditions of your policy.
699 6875
0 0 0 0 0 1250 0

What'’s not covered

Coverages, add-on, exclusions mentioned above are indicative. For more details on risk factors, terms condition
CORP/SUP/OPI/2014/1777

and exclusions, please read the policy wordings available at www.icicilombard.com.

 0 Product Code: 3001
UIN: IRDAN115RP0017V01200102
1

Unique Identification Number (UIN) Details

IRDAN115RP0017V01200102/A0368V01200910
IRDAN115RP0017V01200102/A0027V01201213
IRDAN115RP0017V01200102/A0216V01200910
Zero Depreciation Road Side Assistance Consumable
IRDAN115RP0017V01200102/A0368V0 IRDAN115RP0017V01200102/A0027V0 IRDAN115RP0017V01200102/A0216V0
1200910 1201213 1200910

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 0 Product Code: 3001
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Policy Certificate
Private Car Package Policy

Your Policy Details

Name Telephone no Mobile no Email
PRITI SARDA - 80******49 PR************@GMAIL.COM
Address Policy No E-Policy No
W/O ABHISHEK SARDA, MAHAJANO KA MOHALLA, SADAR BAZAR, 3001/387970609/00/000 -
GACHHIPURA, ITAWA BAMNIYA, ITAWALAKHA, NAGAUR, MAKRANA, Policy Issued On Covernote No
RAJASTHAN, 341504,, NAGAUR, RAJASTHAN - 341504 Apr 04, 2025 387970609
Vehicle Registration No Vehicle Registration Date
RJ37UA7256 Jul 23, 2021
Tenure Period of Insurance
1 Year Apr 07, 2025 00:00 to Midnight of Apr 06, 2026
Nominee Name Relationship Age RTO Location Hypothecated To
- - 0 RAJASTHAN-DIDWANA -
Named Passenger's Nominee Relationship Age GSTIN Number (Customer) Invoice Number
- - 0 100425244741
Servicing Branch Name Servicing Branch Address
Jaipur Unit No.1003 To 1008, 10Th Floor, Signature Towers, Dc 2, Lal Kothi Scheme ,District Shopping Center ,Tonk Road, Jaipur,
Rajasthan-302001

Previous Policy Details

Comprehensive Package
1
Previous Policy No Previous Policy Period Previous Insurer Name Previous Policy Type
2903003124P100409658 07-04-2024 to 06-04-2025 UIIC Comprehensive Package
Previous Year NCB Claims Made Under Previous Policy
35 2

Are you or any of the proposed applicants/beneficial owner a PEP* or Family member/ Close relatives/Associates of PEPs*? No

Vehicle and IDV Details

Registration No. Make Model Type of Body CC/KW Mfg Yr Seating Capacity Chassis No. Engine No.
RJ37UA7256 MORRIS GARAGES HECTOR 2.0 SHARP SUV 1956 2021 5 MZ7BD1D2C4H052065 463445924096457
Vehicle IDV (`) Trailer (`) Non Electrical Accessories (`) Electrical / Electronic Accessories (`) CNG / LPG Unit (`) Total IDV (`)
1250000 0 0 0 0 1250000

Premium Break-up
Own Damage Premium (A) (`) Liability Premium (B) (`)
Basic OD Premium 20894 Basic Third Party Liability 7897
Zero Depreciation (ZD -) 6875 Total 7897
Consumables 1250 Add:
Road Side Assistance (RSA-including Key Protect) 699 Legal Liability to Paid Driver 50
PA Cover for Owner Driver 675
Sub-Total 725
Sub Total 29718
Savings - You have saved the following amount on your premium
Anti-theft Device Discount 500
Sub-Total 500
Total Liability Premium (B) 8622
Total Package Premium (A+B) 37840
CGST ` 3405.60
% 9
SGST ` 3405.60
% 9
Total Own Damage Premium (A) 29218 Total Premium Payable ` 44651

Geographical Area: No Extension Applicable IMT Clauses: 10 , 28 , 22

Compulsory Deductible: ` 2000 Voluntary Deductible: ` 0

Premium Collection No. 1234121323 Premium Amount 44651 Receipt Date 04-04-2025
GSTIN Reg.No 08AAACI7904G1ZN HSN/SAC code 997134/GENERAL INSURANCE SERVICES
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.
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Features of Add-on Covers:

1 List of services for Road Side Assistance : Arrangement of keys,Battery jump start,Message Relay,Flat Tyre support,Towing on breakdown/accident upto 50 km,Alternate
Travel/Taxi Benefits,Breakdown support over phone,Key Protect of Rs.25000,Accommodation Benefits,Arrangement/Supply of fuel
2 Zero Depreciation Coverage : Zero Depreciation covers only the depreciation on the replaced parts. Consumables and HydroStatic Lock are not coverd under Zero
Depreciation unless opted as separate add-on.

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Important Details
This page contains information regarding risk assumption clauses, changes, additions, and grievance redressal.
We suggest giving it a thorough read.

Limits of liability:

Type of claim Liability claim limit Section of the policy

Death or bodily injury Such amount as is necessary to meet the requirements Section II-I(i)
Damage to third party property of the Motor Vehicles (Amendment) Act, 2019 Section II-I(ii)
PA Cover for Owner-Driver ` 1500000 Section III

PA Cover for Owner-Driver under Section III: CSI ` 1500000 for 1 year.

Limitations as to Use: The Policy covers use of the vehicle for any purpose other than: Hire or Reward, Carriage of goods (other than samples of personal luggage), Organised
racing, Pace Making, Reliability trails or Speed testing, any purpose in Connection with Motor Trade.

Driver's Clause: Any person including the 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 and that such a person satisfies the
requirements of Rule 3 of the Central Motor Vehicles Rules, 1989

Important Notice: The insured i s not indemnified if the vehicle i s 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 RIGHT OF RECOVERY". In consideration of the premium for this extension being calculated at a pro-rata proportion of the annual premium, it is hereby
declared and agreed by the insured that upon expiry of this extension, this policy shall be renewed for a period of twelve months, failing which the difference between the
extension premium now paid on pro rata basis and the premium at short period rate shall become payable by the insured. For Legal interpretation, English version will hold
good.

Important Points:
a. Any accidental loss, damage and/or liability caused, sustained or incurred, while vehicle not being registered permanently will not be covered.
b. Any minor scratches to the vehicle, paint fading, wear and tear arising out of normal use and requiring touch-up or minor repair under routine maintenance will not be covered.
c. Any liability of whatsoever nature caused by, contributed by or arising due to the vehicle being driven by a person without having valid driving license will not be covered.
d. In case of total loss / constructive total loss / Total theft / cash loss of the vehicle, the claim will be settled at invoice price i.e amount paid by the insured / policyholder at
the time of purchasing the vehicle, excluding subsidy amount, if included in the invoice, or the Insured declared value (IDV) whichever is lower, subject to terms and conditions
of the policy and admissibility of claims.
( Please visit www.icicilombard.com for the policy wordings, for complete details on terms and conditions governing the coverage and NCB

FASTag: Government of India has mandated electronic toll payments using FASTag to reduce vehicular traffic at toll plazas. Customers are advised to comply with the direction
of the government and get their FASTag from Point of Sale locations at Toll Plazas or from Issuer Agency. Please visit http://www.fastag.org/ for details.

PUC: We have issued the policy basis your confirmation that you hold a valid PUC and/or Fitness certificate, as applicable. Warranted that the insured named herein/owner of
the vehicle holds a valid Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on the date of commencement of the Policy and undertakes to
renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, during the subsistence of the Policy. Further, the Company reserves the right to take
appropriate action in case of any discrepancy in the PUC or fitness certificate.

Changes Required: If you require any changes in the Certificate of Insurance cum Policy Schedule, you can do so via an endorsement. You are requested to inform us by
writing to customersupport@icicilombard.com, visiting our website, or calling our 24 hour toll free helpline on 1800 2666. In case of any discrepancy with respect to the policy,
please revert within 15 days from the policy start date. Absence of any communication within a period of 15 days of the date mentioned on this letter, would mean that the
issued policy is in order and as per your proposal.

Grievance Redressal: For resolution of any query or grievance you may contact us on our toll free no. 1800 2666, or visit any of our branch offices. You can also write to us at
customersupport@icicilombard.com. For detailed grievance redressal mechanism please visit the "Grievance Redressal" section on our website www.icicilombard.com.
The Company reserves the right to cancel this Policy immediately upon becoming aware of any mis-representation, fraud, non-disclosure of material facts or non-cooperation by
or on behalf of the Insured; the Company is not obliged to refund the premium paid under this Policy
In case of total loss / constructive total loss / Total theft / cash loss of the vehicle, the claim will be settled at invoice price i.e amount paid by the insured / policyholder at the
time of purchasing the vehicle, excluding subsidy amount, if included in the invoice, or the Insured declared value (IDV) whichever is lower, subject to terms and conditions of
the policy and admissibility of claims.
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 XI of Motor
Vehicle Act, 1988. In witness whereof, this Policy has been signed at Mumbai on this date of Apr 04, 2025 in lieu of Covernote no. 387970609. The stamp duty of ` 0.5 paid
vide deface no. CSD10520244764 dated Oct 04, 2024.

Disclaimer: The information provided above i s based on the information received from you and accordingly, the policy has been processed. Coverage of risk is subject to
realisation of the full premium, post which, insurance coverage under the policy would commence. In case the premium is not received by us due to cheque dishonour or any
other reason, the insurance cover shall be void ab-initio.

Disclaimer:The information provided i s merely illustrative and shall not be construed to be an evidence of existence of a contract of insurance. This document is to be read in
conjunction with the policy wordings and shall be considered null and void without the same. Please visit www.icicilombard.com for policy wordings and complete details on
terms and conditions governing the coverage and NCB.
-
This policy is underwritten on the basis of the information provided by you and as detailed in this document. On renewal, the benefits provided under the policy and/or terms and
conditions of the policy including premium rate may be subject to change.
*Quality assurance of 6 months or 6000 km (whichever comes early) i s available only at our preferred partner garages. #Approval would be subject to physical survey of the
vehicle wherever deemed necessary. The insurer reserves the right to conduct a physical survey in accordance with the regulatory prescriptions. The policy is valid subject to
realisation of cheque. We accept premium only via legally recognized modes. In case of dishonour of premium cheque, the company shall not be liable under the policy and
the policy shall be void ab-initio.

Update your bank details in your policy: Updating your bank details with us would help facilitating future transactions. Bank details can be easily updated using "IL - Take
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UIN: IRDAN115RP0017V01200102
1
Update your bank details in your policy: Updating your bank details with us would help facilitating future transactions. Bank details can be easily updated using "IL - Take
care" App.

Policy Issuing Office: ICICI Lombard General Insurance Company Limited, ICICI LOMBARD HOUSE, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai 400 025.

Agent/Partner Details
POS15281
Here are the details of your agent

Point of Sale (POS) Details

POS Number POS Name Contact Details PAN Card Number
200538573598 RAKESH MALAK 9983313500 EHIPM4278K

Agency Code : POS15281

Agency Name : RAKESH MALAK
Agent's Contact No : 9983313500
Contact Person : D:/CLICK/images/Gaurav_Arora.png

Click here or scan the QR code to view the Customer Information Sheet (CIS). It provides an overview
of the policy features, service and claim processes, as well as other important terms.

Signature Not Verified

Digitally signed by DS ICICI
LOMBARD GENERAL
INSURANCE CO LTD 1
Date: 2025.04.04 12:12:59 IST
CORP/SUP/OPI/2014/1777