THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Commercial Vehicle Liability Only Policy
UIN Number - IRDAN190RP0004V01200203
Policy Number :33140031240200003456
POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
AJMER D.O. (331400), NAME: D.K. SINGHAL - (2D6483814) Ajmer Non Suit Claim Hub (339001)
SHANTI MANSION, , KOTWALI SCHEME, , Mr. Ravi Agarwal - (NIAAG00016968), ADDRESS: Shanti Mansion, Kotwali Scheme, Khailand
KHILAND MARKET , PHONE NUMBER:9214349882 / 9414378983 / Market, Ajmer-305001 , , , RAJASTHAN , 305001.
RAJASTHAN , 305002. LAND/FAX NUMBER:/ PHONE NUMBER: 1234567890 /
PHONE NUMBER:01452630971 / EMAIL:
[email protected] / MOBILE NUMBER:
01452425847 Email:
[email protected] FAX NUMBER:01452420748 / NA
Email:
[email protected] INSURED DETAILS
Insured's Name MAHESH CHAND AGARWAL Customer ID PO61241340 (PAN No
:aatpa1987f)
Insured's Address SO SH DEOKI LAL AGARWAL,RO DEVKI NANDAN MARG Contact Number / / XXXXXX4534
ADARSH NAGAR,,
AJMER ,RAJASTHAN, 305001
Email manojagarwaltransport@g
mail.com
GSTIN 08AATPA1987F1ZG
POLICY DETAILS
Period of cover 18/08/2024 12:00:01 AM to 17/08/2025 11:59:59 PM Receipt Number 33140081240000003643 -
07/08/24
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 33140031230200002509
VEHICLE DETAILS
Geographical Area / Zone: India/C Year of manufacture: 2016
Type of Commercial A - Goods Carrying Sub Type: Other than 3 wheeler -
Vehicles: Public Carrier
Name of the Financier: Chassis no./Engine no.: MB1TRKHDPGW8277/GHP
Z146722
Type of fuel: Diesel Cubic capacity ( cc): 0
Type of body: Open Gross Vehicle Weight 45500
(GVW):
Make/Model: ASHOK LEYL/4019 IL Registration no. RJ-02-GB-4350
Seating capacity including 3 Variant: 4019 IL
Driver:
Automobile Association Colour: OTHER COLOR
membership:
Cover Note No/Cover / Name of registration Alwar
Note Issue Date: authority:
FASTag ID:
INSURED DECLARED VALUE (Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel/CNG/LPG kit Total Value
0 0 N/A N/A 0
SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 0 Basic TP Premium 44242
(+) Additional OD Premium for Bi-Fuel/CNG/LPG 0 0
(+)LL to paid driver conductor cleaner employed for
Signature Not
Verified
Digitally signed
by DHIRAJ Policy No. : 33140031240200003456Document generated by 34662 at 2024/08/07 15:32:10.
KUMAR
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2024.08.07
15:32:10 IST Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
oprn 150
Calculated OD Premium 0 Calculated TP Premium 44392
Total OD Premium (Rs) 0 Total TP Premium (Rs) 44392
Net Premium (Rs) 44,392
GST (Rs) 5,338
Total Payable (Rs) 49,730
Total Payable in Rs(in words): RUPEES FORTY-NINE THOUSAND SEVEN HUNDRED THIRTY ONLY
GSTIN(Issuing Office) 08AAACN4165C2ZQ
SAC 997134 (Motor vehicle insurance services)
Limitation as to use:The policy covers use only under a permit within the meaning of the Motor Vehicles Act, 1988 or such a carriage falling
under sub-section (3) of Section 66 of the Motor Vehicles Act, 1988.The policy does not cover use for: a)Organized racing b) Speed testing
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 7,50,000
For individual covers (OD) in RS:0 Compulsory excess in Rs:NA
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive: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 requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
PA cover for Owner Driver
Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
none 0 none none none
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
NA NA NA NA
Premium and GST Details
Rate of Tax Amount in INR
Premium Rs150
SGST 9 14
CGST 9 14
IGST 0 0
Premium Rs44242
SGST 6 2655
CGST 6 2655
IGST 0 0
In witness where of this policy has been signed at AJMER D.O. on this 07/08/2024
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to Package/Liability policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,40.
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 Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company website.
Policy No. : 33140031240200003456Document generated by 34662 at 2024/08/07 15:32:10.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
I/We hereby certify that the policy to which this Certificate For and on behalf of The New India Assurance Company Limited
relates as well as this Certificate of Insurance are issued in
accordance with the provisions of Chapter X and XI of M.V. Act,
1988.
Date of Issue: 07/08/2024
Duly Constituted Attorney(s)
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.
Tax Invoice No : 33140024E0004591
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
Policy No. : 33140031240200003456Document generated by 34662 at 2024/08/07 15:32:10.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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