IRDA Regn No - 137 SHRIRAM GENERAL INSURANCE COMPANY LIMITED
E-8,EPIP,SITAPURA INDUSTRIAL AREA , JAIPUR
RAJASTHAN-302022
CONTACT (TOLL-FREE):1800 103 3009 / 1800 300 30000
CERTIFICATE CUM POLICY SCHEDULE
PRIVATE CAR PACKAGE POLICY - ZONE B
MOTOR PRIVATE CAR (PACKAGE POLICY) - UIN NO. IRDAN137P0016V01200809 - SAC Code. 997134
Issue Office: 10019 - Address:- E - 8, RIICO INDUSTRIAL AREA SITAPURA -JAIPUR RAJASTHAN 302022 Tel
Policy No :10019/31/25/085058 Geographical Area INDIA
Insured's Code/ Name: 105799780/Ms ANTIKA
Address : C/O SMT SHARDA DEVI HOUSE NO 14 OPPOSITE WAREHOUSE SRI KARANPUR DIST SRI GANGANAGAR RAJASTHAN SRIGANGANAGR
,RAJASTHAN ,335073
Executive: NA0000000100 Broker Details / W.A.:LCN000000009 Policybazaar Insurance Brokers Private Limited.
Contact No:18002585970
Period of Insurance : From 00:00 on 13-01-2025 00:00 To 12-01-2026 Midnight Cvr Note No. - Issue date
Gross Premium: 2,723.00 GST:490.00 Cess :0 Total: 3,214.00
Registration Engine No Type of Body / Cubic Capacity / Date Of Regn / Seat Cap
Make - Model
Mark & Place Chassis No Fuel Type Year of Manf Delivery (Incl Driver)
RJ-18-CB-7119 G3HAGM426724 HYUNDAI 814
21/05/2016 4+1
Jhunjhunu MALA351ALGM469196 EON MAGNA PLUS Petrol 2016
IDV For the IDV For Non Electrical Electrical SI for Named
CNG KIT SI Total Value
Vehicle Trailers Accessories Accessories Persons
205684 0 0 0.00 205684
A. OWN DAMAGE SCHEDULE OF PREMIUM B. LIABILITY
OD TOTAL 629.00
BASIC TP COVER 2,094.00
TOTAL PREMIUM 2,723.00
CGST @ 9% 245 TP TOTAL 2,094.00
SGST @ 9% 245
FINAL PREMIUM 3,214.00
* NCB discount - 20% Previous Policy : 211200/31/2024/422350 - Previous Insurer : The Oriental Insurance Company Ltd
(UIN No IRDAN137A0006V01200910)ADD-ONS :- Not Included
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).
Deductibles under Section-I :Compulsory Deductible Rs. 1,000.00
Subject to IMT Endorsement Printed herein/attached to : ,IMT 22
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) : 0
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.
Limitations as to Use
Use only for social, domestic and pleasure purposes and for the insured's business or profession. The Policy does not cover use for hire or reward, tuition, racing, pacemaking,
reliability trial, speed testing, carriage of goods(other than samples or personal luggage) in connection with any trade or business or use for any purpose in connectionwith
Motor Trade
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 the policy 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 HEAD OFFICE on Fri Jan 10 08:30:11 IST
IMPORTANT NOTICE
The Insured is not Indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR
AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.
Preinspection Report: Not Applicable Broker
POS Details : Name : - ID No : 2
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.
For instant renewal of your insurance policy, Log on to www.shriramgi.com
In case of Claims, Please contact us at: Toll Free No - 180030030000, 18001033009 Email id - chd@shriramgi.com
For and on behalf of
SHRIRAM GENERAL INSURANCE COMPANY LTD
Place : Date : Fri Jan 10 08:30:11 IST
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 AUTHORISED SIGNATORY
All the Amounts mentioned in this policy are in Indian Rupees Note :-Claim intimation after 48 hours will be
GSTIN No. - 08AAKCS2509K1Z3 considered as delayed intimation.