Bajaj Allianz General Insurance Company Ltd.
GE Plaza, Airport Road, Yerwada, Pune - 411006(India)
CERTIFICATE CUM POLICY SCHEDULE

Policy Servicing Off: 497/498, 5th floor, Isana Kattima building,, Poonamallee High Road, Arumbakkam,, , , Chennai-600106 Phone No
:044-43904400
Policy Number OG-18-1501-1812-00000800 Product Commercial Vehicle - Class C(ii)
Vehicle Type Passenger Carrying - 4 Wh & CC> 6 And 3 Wh & CC>17
Period Of Insurance From: 30-Sep-2017 00:00 Policy issued on 23-Sep-2017 -
To: 29-Sep-2018 Midnight Cover Note No /
Application No Scrutiny No 74851671
Insured Name M/S. MOHAMED SATHAK A.J. COLLEGE OF Zone C
ENGINEERING
Insured Address OLD MAHABALIPURAM ROAD, EGATTUR, , ,,
CHENNAI - 603103
Customer ID 84803655 Premium Payer ID 84803655
Transaction Id
HYPOTHECATED WITH : SUNDARAM FINANCE LTD Policy Status ISSUED
GSTIN / UIN NA STATE CODE / NAME 33 - Tamil Nadu
Registration Make SubType Model CC Mfg year Seat Cap Vehicle/Trailer Engine Number
No. Chassis No
TN21Q3750 SWARAJ ORDINARY ZT 54 ED EL- 0 2003 39 070845 R64051
MAZDA BUS (39 SEAT- WB
ER)

Vehicle IDV Elec Acc Non Elec Acc Trailer Trailer Reg No CNG/LPG Unit Total Sum Insured
363250 0 0 0 363250
SCHEDULE OF PREMIUM
OWN DAMAGE LIABILITY
Total Own Damage Premium: 979.459 Basic Third Party Liability 44571
LL For Operation/Maintenance For 1 Person 50
Total Liability Premium: 44621
Total premium 45600.459
Special Discount 0
Net Premium 45600
State GST (9%) 4104
Central GST (9%) 4104
Final Premium Rs. 53808 ***All premium Figures are in Rupees
Geographical Area : INDIA No Claim Bonus : -50% Voluntary Excess : Nil
Compulsory Deductible : Rs.1500 Additional Compulsory Deductible : Rs.0
Previous Insurer - Bajaj Allianz General Insurance Co Ltd.Previous Policy No -OG-17-1501-1812-00000636
Expiry On - 29-SEP-17
The above Total OD Premium is inclusive of all applicable Loading/Discounts viz (Automoble Association Membership,Voluntary Excess,Anti-Theft,Handicap Per-
son,Driver Tution,Fibre Glass,Cng/Lpg Unit,Geographical Extn,Imported Vehicle etc wherever applicable)
LIMITS OF LIABILITY: Under Section II-1(i) of the policy -> Death of or bodily injury : Such amount as is necessary to meet there requirements of the Motor
Vehicles Act,1988. Under Section II-1(ii) of the policy -> Damage to Third Party Property : Rs.750000/-
LIMITATION AS TO USE: 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 Policy does not cover use for : Organised racing, Pace Making, Reliability Trials, Speed Test-
ing,Use whilst drawing a trailer except the towing (other than for reward) of any one disabled Mechanically propelled vehicle.
DRIVER : : Any person including the insured : Provided that a person driving holds an effective driving licence at the time of the accident and is not disquali-
fied from holding or obtaining such a licence. Provided also that the person holding an effective Learner's licence may also drive the vehicle when not used for
the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
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 RIGHT OF RECOVERY".
Subject To IMT Endorsement Nos : 21, 7,28, & Policy wordings attached herewith
Agency Code BAG100007481 Channel Name : ML
Agency Name : JUHIJAHAN J
Contact No : 09884128820/09884128820
Email - [email protected]
Damage Details as per Annexure I
Premium Collection Details :- [Receipt No/Collection No/Amount] 1501-00882465 / 74851671 / Rs. 6000 , 1501-00882462 / 74851671 / Rs. 47808 ,
*** If premium paid through cheque, the policy is void ab-initio in case of dishonour of cheque.
This certificate of insurance is issued in accordance with the provision of Chapter X and Chapter XI of M.V. Act, 1988.
Damage Details Annexure : - Preinspection No :
Remarks -

In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858 (Toll Free) / 91-020-30305858
(chargeable, add area code before this number in case of mobile call) or email us at '[email protected]'.
74851671/-/10049763/0/-
This is a one page Policy Document [without enclosing the Terms and Conditions (T&C) of the Policy] issued by the Company, pursuant to the authorization of Insured to display the T&C of the Policy on its website (www.bajajallianz.com) that enables access by the In-
sured. The T&C of the Policy are available on the Company's website and can be accessed by the Insured.
Kindly contact our nearest / local office(s) for No Claim Bonus Confirmations.

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For & On Behalf of Bajaj Allianz General Insurance Company Ltd.

Regd. Office : GE Plaza, Airport Road, Yerawada,Pune - 411006 (India),A Company incorporated under Indian Companies Act, 1956 and
licensed by Insurance Regulatory and Development Authority of India [IRDA] vide Reg No.113, Corporate Identification Number
U66010PN2000PLC015329.BAGIC GST No : 33AABCB5730G1Z4 | Principal Location : 497/498, 5th floor, Isana Kattima building, Poo-
namallee High Road, Arumbakkam, Chennai - 600106 PH:044-43904400 | Services Accounting Code : 997134 - Motor vehicle insur-