This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: SUNITAGUPTA
Date: Fri, Jun 16, 2023 12:43:04 IST
Location: NOIDA
Reason: Signing Policy for OICL
MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE
STANDALONE OWN DAMAGE(OD)-TWO WHEELER POLICY - ZONE A
UIN : IRDAN556RP0002V01201920
Road Side Assistance included in this policy - Toll free No. 8447642311 *Conditions Apply
Policy No : 211200/31/2024/68909 Prev Policy No : -

Cover Note No : - Cover Note Dt :

Insured's Code : 170552088 Issue Office Code : 211200
Insured's Name : Jeetu Shrivastwa (GSTIN: 0) Issue Office Name : DO II NEW DELHI (GSTIN:
07AAACT0627R1Z1)
Address : A-303 OM TIRUPATI CHSL,NR BHARAT Address : 16/20, WEA, FIRST FLOOR,NEAR SHASTRI
GAS AGENCY EVERSHINE CITY,VASAI PARK,
EAST PADAM SINGH ROAD, KAROL BAGH
PALGHAR,PALGHAR,MAHARASHTRA,
NEW DELHI
NEW DELHI DELHI 110005
THANE
MAHARASHTRA 401208
Tel /Fax /Email : / / 9689260311 / Tel /Fax /Email : 011-41052050, 41062050, 8851779656 /
[email protected] 011-41052050 /
[email protected]

Local Servicing Office Code : 211200

Local Servicing Office Details : DO 2 NEW DELHI,16/20, WEA, FIRST FLOOR,NEAR SHASTRI PARK,,PADAM SINGH

Agent/Broker Details
Dev.Off.Code :
Agent/Broker : LC0000000660 M/S POLICYBAZAAR INSURANCE BROKERS PRIVATE LIMITED
Address : Plot No. 119, Sector-44, Gurgaon,, Gurgaon, Haryana, 12200,Tel - 1800-258-
5970,GURGAON,HARYANA,122002

Tel /Fax /Email : 1800-258-5970/1800-258-5970//

Period of Insurance : FROM 00:00 ON 21/06/2023 TO MIDNIGHT OF 20/06/2024

Collection No & Dt : 3 2005071421 - 16/06/2023 GST INVOICE NO :0722177886 UIN :0

Gross Premium : 100 GST : 18 Stamp Duty : .5 Total : 118

Geographical Area : IND Area Extension :

Particulars of Insured Vehicle:

Registration Mark Engine No. & Year Of Type Of Seating Capacity Cubic
& Place Chassis No. Manufacture Body (including Driver) Capacity
Make - Model

MH 03 CY 7994 BR1BJ2502330 - TVS-APACHE RTR 200 4V FI (200 CC) 2018 OTHERS 1+1 200
MD637BR13J2B02
Mumbai East 376

Limitations as to use:

1 The policy covers use of the vehicle for any purpose other than hire or reward ,tuition,organized racing,pace making,reliability
trial,speed testing,carriage of goods(other than samples or personal luggage) or use for any purpose in connection with Motor Trade.

Driver :
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:
Details of TP insurance
Name of Insurer & Address Policy No Period of Insurance
01-Jan-2019 31-Dec-2023 TO MIDNIGHT OF

Place : NEW DELHI

Date : 16/06/2023
Page 1 of 3
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: SUNITAGUPTA
Date: Fri, Jun 16, 2023 12:43:04 IST
Location: NOIDA
Reason: Signing Policy for OICL
Attached to and forming part of policy number 211200/31/2024/68909

ROAD, KAROL BAGH,NEW DELHI,,,011-41052050, 41062050,

8851779656,8851779656,[email protected]

If the Insurance
*This TP Insurance declaration
excludes provided above
all pre-existing damagesby the Insured is found incorrect/or the policy does not exist/ lapsed/Cancelled due to any
reason, then subject policy becomes Null and Void from the date TP coverage has ceased to exist.
*This insurance excludes any loss/liability arising out of ThirdDeclared
Insured's Party or Value
personal accident.

Non Electrical Electrical

For the Vehicle For the Side Car Accessories Accessories Value of LPG/CNG Total Value

34,283 0 0 0 0 34,283

SCHEDULE OF PREMIUM

OWN DAMAGE

BASIC OD COVER 645.55 TOTAL PREMIUM 100.00

LESS :Discount 452.00 STAMP DUTY 0.50
BASIC OD TOTAL 193.55 ADD :IGST 18.00
MOTOR TOTAL OD 97.00 TOTAL AMOUNT 118.00
OD TOTAL 194.00
LESS :NO CLAIM BONUS-GR27 96.78
Please note the coverage under this policy is restricted to Own Damage section only and no other
liability in connection with the vehicle
* NCB discount - 50 %
Deductibles under Section-I : COMPULSORY DEDUCTIBLE Rs.100

Subject to IMT Endorsement Printed herein/attached to : IMT-20

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

Hypothecation Agreement with: - IDFC FIRST BANK

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 Licence 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 NEW DELHI
on 16-JUN-23
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".

Entered By : POLICY BAZAR

Examined By : POLICY BAZAR

Policy Printed By : PRTL IP :

Digitally Signed
Policy Printed On : 16-JUN-23 12:42:42 MAC :
Authorised Signatory

Place : NEW DELHI

Date : 16/06/2023
Page 2 of 3
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: SUNITAGUPTA
Date: Fri, Jun 16, 2023 12:43:04 IST
Location: NOIDA
Reason: Signing Policy for OICL
Attached to and forming part of policy number 211200/31/2024/68909

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
and through other digital platforms including Whatsapp (send 'Hi' to 9560711200).

Place : NEW DELHI

Date : 16/06/2023
Page 3 of 3