MAGMA HOUSE, 24 Park Street , Kolkata -700016

COMMERCIAL VEHICLE LIABILITY ONLY POLICY

CERTIFICATE OF INSURANCE CUM SCHEDULE
Policy Servicing office 2ND FLOOR, SURVEY NO. 134/3, PLOT NO. 16 TEACHERS'' COLONY, GURUNANAK ROAD,PATAMATA KRISHNA - 520008 ANDHRA PRADESH
PH: (90) 30003976 FAX:
Policy No P0099874587/6325/412574
Insured Mr RANI KALVAPALLI
Address K CHANDRA SEKHAR, #3/57, KADHEREPALLI,
U.RAJUPALEM, Period Of Insurance 00:00 Hrs of 29/03/2018
VEERAPUNAYUNIPALLY, To Midnight of 28/03/2019
KADAPA
Contact Number ANDHRA PRADESH 516321
Email ID: 9885715455
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Registration PASSENGER
Year of CUBIC VEHICLE SUB
Mark & No. & Engine No. Chassis No. Make/Model/Type of Body CARRYING SEATING CAPACITY
Manufacture CAPACITY CLASS
RTA Location CAPACITY
C1B PCV 3
AP 04 TW
Wheeler not
5843 / 2016 BAYWGG30042 MD2A96AY4GWG02213 BAJAJ RE COMPACT BSIV 470 3 4
exceeding 6
PRODDATUR DIESEL /RICKSHAW
passengers
LIABILITY
LIABILITY(B)

Basic - TP 2,218.00
PA Owner Driver -SI Rs.200000 100.00

LL to Paid Driver IMT 28 50.00

Legal Liability to Passenger 3,183.00

Sub Total 5,551.00

Less:

TPPD Discount - IMT 20 150.00

Sub-Total Deductions 150.00

Premium Computation
Total Liability Premium 5,401.00
CGST @ 9% 487.00

SGST @ 9% 487.00

TOTAL 6,375.00

LIMITATIONS 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 Vehicle's Act 1988.
The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a trailer
except the towing (other than for reward) of any one disabled Mechanically propelled vehicle (only for Passenger Carrying Veh icles).
Persons or classes of
persons entitled to drive: Any person including Insured:

Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or
Stage carriage/Contract
obtaining such a license.Provided also that the person holding an effective learner's license may also drive the vehicle when not used
Carriage/ Private Service
for the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of Th e Central
Vehicle
Motor Vehicles Rules, 1989.
Provided that the 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
Non-transport Vehicles
for the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of Th e Central
Motor Vehicles Rules, 1989.
LIMITS OF LIABILITY
Under Compulsory excess in respect of each and every Under In respect of any Under Damage to Third Party Property Under PA Owner – Driver as
Section claim under Sec I of motor policy Section one accident -- As Section Rs. 6000/- in respect of any one Section III: per premium
I II-I (i) per Motor Vehicle II-I (ii) claim or series of claims arising computation table
Act out of one event.
Subject to I.M.T Endorsement Nos. IMT 20,IMT 28
NOMINATION DETAILS
Name Of the Nominee Date of Birth of Nominee Age of Nominee Relationship Percentage
DUMMY 0 0 0 0
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 X
and chapter XI of M.V. Act, 1988.
Premium Collection Details :- [Collection No / ReceiptDate / Amount] : P/874587/18/100032125- 29/03/2018 , 6,375/-
For Magma HDI General Insurance Co. Ltd.
In case of Claims, please contact us at 1800 - 3222 - 3202

Date of Issue : 29/03/2018

Place : Kolkata

Authorised Signatory
Service Tax Registration no : AAGCM1685CSD001
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". For legal interpretation English version will be good.

For Complete details of coverage , terms, conditions & exclusion plea se refer the standard policy wording attached with this schedule

IMPORTANT - 1) The Validity of this Certificate of Insurance cum Schedule is subject to realisation of the premium cheque.
2) No Claim Bonus will only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy.