This Document is Digitally Signed

Signer: MILAP CHAND

Date: Thu, Jan 6, 2022 16:20:58 IST
Location: NOIDA
Reason: Signing Policy for OICL

MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE

PRIVATE CAR PACKAGE POLICY - ZONE B

Policy No : 161602/31/2022/4913 Prev Policy No : -

Cover Note No : - Cover Note Dt :

Insured's Code : 148761793 Issue Office Code : 161602

Insured's Name : INFIGO LIFESCIENCES PVT. LTD. (GSTIN: Issue Office Name : BO RATNAGIRI (GSTIN:
0) 27AAACT0627R4ZW)

Address : 103, 1ST FLOOR, TERMINAL 9, NR. VILE Address : "SADACHAR MANDIR", SHERE NAKA,
PARLE POLICE STATION, VILE PARLE (E), NEAR DR.AURANGABADKAR'S
MUMBAI 400057 CHINTAMANI HOSPITAL,
ZADGAON,RATNAGIRI

MUMBAI MAHARASHTRA 400057

RATNAGIRI MAHARASHTRA 415612
Tel /Fax /Email : 0 / / 9028084050 / [email protected] Tel /Fax /Email : 02352-222715 & 224874 / Fax-224874 /
[email protected]
Lead/Breakin No : /

Agent/Broker Details
Dev.Off.Code : NA0000001984 BO RATNAGIRI DIRECT
Agent/Broker :: BA0000025345 AMIT S SARDESAI
Address : NARHARI NIWAS,AT/POST- VERAVALI BK,TAL- LANJA, DIST-
RATNAGIRI,RATNAGIRI,MAHARASHTRA,415612
Tel /Fax /Email : 0/MR. DESAI MILIND J./02351-203025, 232025, 692350/NA

Period of Insurance : FROM 15:46 ON 06/01/2022 TO MIDNIGHT OF 05/01/2023

Collection No & Dt : DC_I_IND 3164006972 - 06/01/2022 GST INVOICE NO :2720593747 UIN :0

Gross Premium : 12,780 GST : 2,300 Stamp Duty : .5 Total : 15,080

Geographical Area : INDIA Area Extension :

Particulars of Insured Vehicle:

Registration Mark Engine No. & Type Of Body Cubic Year Of Seating Capacity
& Place Chassis No. Make - Model Capacity Manf. (including Driver)
Type Of Fuel
MH 02 EZ 7523 G12BN631928 MARUTI-MARUTI OTHERS 1196 2019 4 + 1
EECO CNG 5- STR
Mumbai West MA3ERLF1S006525 PETROL + CNG
A/C
51

Limitations as to use:

1 The Policy covers use of the vehicle for any purpose other than a) Hire or Reward b) Carriage of goods (other than samples or
personal luggage) c) Organized racing d) Pace making e) Speed testing f) Reliability Trials g) Use in connection with Motor
Trade

Driver: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.

Limit of Liability:Under Section II-I(1) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-I(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 Registered Owner Cum Driver (CSI) : Rs. 0
*This insurance excludes all pre-existing damages

Place : RATNAGIRI
Date : 06/01/2022
Page 1 of 3
 This Document is Digitally Signed

Signer: MILAP CHAND

Date: Thu, Jan 6, 2022 16:20:58 IST
Location: NOIDA
Reason: Signing Policy for OICL

Attached to and forming part of policy number 161602/31/2022/4913

Insured's Declared Value

For the Vehicle For Trailers Non Electrical Electrical Value of CNG Total Value
Accessories Accessories LPG Kit

2,71,404 0 0 2,71,404

SCHEDULE OF PREMIUM

A. OWN DAMAGE B. LIABILITY

BASIC OD COVER 8,661.00 ADD :Other single Fuel Cover(TP)-GR42(b) 60.00

MOTOR OD BASIC - NEW 5,395.24 BASIC TP COVER 3,221.00
ADD :ENGINE PROTECT COVER 679.00 BASIC TP TOTAL 3,221.00
LESS :HEAD OFFICE DISCOUNT 667.76 ADD :PA-UN-NAMED-GR36B2 200.00
LESS :UNDERWRITER DISCOUNT 2,598.00 ADD :LL-PAID DRIVER, 50.00
LESS :CC IS 1500CC OR LESS AND IDV 102.00 CONDUCTOR,CLEANER-IMT-28
RS.10LACKHS OR LESS TP TOTAL 3,471.00
BASIC OD TOTAL 5,972.24 TOTAL PREMIUM 12,780.00
ADD :Add on cover Consumables 380.00
STAMP DUTY 0.50
ADD :ADD-ON COVER NIL DEPRECIATION 2,598.00
ADD :CGST 1,150.00
POLICY
ADD :Other single Fuel Cover(OD)-GR42(b) 299.00 ADD :SGST 1,150.00
OD TOTAL 9,249.00 TOTAL AMOUNT 15,080.00
MOTOR TOTAL OD 9,249.00

Deductibles under Section-I : Compulsory Deductible 1000

Subject to IMT Endorsement Printed herein/attached to : IMT-25 , IMT-22 , IMT-29 , IMT-16 , IMT-28 , OIC-1:Nil Depreciation Cover

Details of IMT Endorsements are also available on the Company¿s Web Portal www.orientalinsurance.org.in

Hypothecation Agreement with: -

Hire Purchase/Lessor Agreement with: -

In the event of a claim under the policy exceeding Rs.1lac or a claim for refund of premium exceeding Rs1lac,the insured will comply with
the provisions of the AML policy of the Company.The AML policy is available in all our operating Offices as well as company's website.
The insurance under this policy is subject to conditions, clauses, warranties, exclusions, IMTs and OIC endorsements mentioned herein
above which are available on Company's website: www.orientalinsurance.org.in or on demand from the policy issuing office.

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).
Claim is not admissible if Driving License is found fake or is not valid whether or not in the knowledge of the insured.
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 BO RATNAGIRI
(GSTIN: 27AAACT0627R4ZW) on 06-JAN-22
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 MVAct, 1988 is
recoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".

Place : RATNAGIRI
Date : 06/01/2022
Page 2 of 3
 This Document is Digitally Signed

Signer: MILAP CHAND

Date: Thu, Jan 6, 2022 16:20:58 IST
Location: NOIDA
Reason: Signing Policy for OICL

Attached to and forming part of policy number 161602/31/2022/4913

For and on behalf of

The Oriental Insurance Company Limited
Entered By : MR. SACHIN P. TANAVADE

Examined By : MR. SACHIN P. TANAVADE

Policy Printed By : OICL IP :

Policy Printed On : 06-JAN-22 16:16:48 Authorised Signatory

In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485.
CIN: U66010DL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees
IRDA Regn. No. 556 - Now you can buy and renew selected policies online at www.orientalinsurance.org.in

Place : RATNAGIRI
Date : 06/01/2022
Page 3 of 3