Cholamandalam MS General Insurance Company Limited

Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001.
Toll Free: 1800 208 5544 | Ph: 044 4044 5400 | Fax: 044 4044 5500 |
PAN AABCC6633K CIN: U66030TN2001PLC047977 IRDAI Regn. No.123

Policy Schedule cum Certificate of Insurance

Motor Commercial Vehicle Package Policy - For Goods Carrying Vehicles : UIN: IRDAN123RP0003V03100001

Policy Number : Certificate Number :

Period of Insurance : From 14:33 hrs on 02/08/2023 to Midnight of 01/08/2024 23:59
3379/03587004/000/00 3379/03587004/000/00

Name & Communication Address : Registration Address :

JADHAV EKNATH PANDHARINATH A/P VAR BETMALA JAWALE KADLAGSANGAMNER Ahmadnagar
A/P VAR BETMALA JAWALE KADLAGSANGAMNER AHMADNAGAR Maharasht,undefined,undefined,SANGAMNER,MAHARASHTRA,422605
MAHARASHT,UNDEFINED,UNDEFINED,SANGAMNER,MAHARASHTRA,422605
Business / Profession :

MH-17-AHMED NAGAR
EIA : Date of Registration 14/07/2020 Place of Registration
(MAHARASHTRA)

PAN : GSTIN : Geographical Area : India

SACHIN EKNATH
Nominee Name Nominee Relation Financier Name & Address
JADHAV

PARTICULARS OF VEHICLE INSURED

Registration Mark MH-17-BY-5910 Engine No TNL1C44649 Chassis No MA1ZN2TNKL1C30001

GVW 2995 GVW as per RC 2995 Body Type CLOSEBODY

BOLERO - PIKUP FB 1.3T PS PIKUP FB 1.3T PS

Make MAHINDRA Model Variant Year of Mfg 2020 Cubic Capacity 2523
XL BSVI XL BSVI

Fuel used DIESEL Total Seating Capacity including Driver 6 Contract No

3 wheeler / other than 3 wheeler : Other than 3

Driver 1 Cleaner 1 Conductor 0 Public/Private Carrier Public
wheeler

For Vehicle 10,17,806 Non-Electrical Accessories 0

IDV (Insured's Declared Value) in Rupees :
(Rs) 10,17,806
Electrical/Electronic Accessories 0 Value of CNG/LPG kit Total Value 10,17,806

Premium COMPUTATION TABLE

A.OWN DAMAGE Sum Insured(Rs) IMT Premiums(Rs) B.LIABILITY Sum Insured(Rs) IMT Premiums(Rs)

Basic OD 10,17,806 17,568 Basic TP 16,049

CNG Kit - OD 0 CNG Kit - TP 25 0

IMT Cover 23 2,636 LL to Paid Driver 28 50

Electrical or Electronic Accessories 24 0 Geographical Extension - TP 1 0

Non Electrical Accessories 0 LL to cleaner 50

Geographical Extension OD 1 0 LL to Coolies 0

Less: Anti-Theft Device 10 TOTAL PREMIUM (B) 16,149

Less: No Claim Bonus Discount (20%) 4,040 C. PERSONAL ACCIDENT COVERS

Less: Experience based discount 12,123 CPA for owner driver 15,00,000 325

Experience based loading 0 PA cover for other than Owner-driver 15 -

TOTAL PREMIUM (A) 4,041 TOTAL PREMIUM (A+A1+B+C) 20,515

CGST (6%) 0 SGST (6%) 0 IGST (12%) 1938 CGST (9%) 0 SGST (9%) 0 IGST (18%) 787

Kerala Cess(1%) TOTAL AMOUNT Rs 23,240

Refer our website for Policy Wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list. Call Toll Free: 1800 208 5544 SMS CHOLA to 56677 |
Visit www.cholainsurance.com | Email [email protected]. Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services
offered. To opt out from the facility, please register under Do Not Call section on our website.
 Cholamandalam MS General Insurance Company Limited
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001.
Toll Free: 1800 208 5544 | Ph: 044 4044 5400 | Fax: 044 4044 5500 |
PAN AABCC6633K CIN: U66030TN2001PLC047977 IRDAI Regn. No.123

Sum Insured Time

A1. ADD-ON COVERS UIN Options Premium (Rs.)
(Rs.) Excess Consolidated Stamp Duty Paid to Commercial Taxes and Registration (j1)
Department, Tamil Nadu.
Tipper Jack 0 Subject to I.M.T. Endt. Nos. and Memorandum: 21,40,23
Compulsory deductible under Section RS.500
Additional Imposed deductibles under Section Rs.0
Nil Depreciation Cover 0

TOTAL PREMIUM (A1) 0

LIMITATIONS 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 Vehicles
Act 1988..The Policy does not cover use for a) Organised Racing b) Pace Making c) Reliability Trials d) Speed testing
DRIVER CLAUSE: Any person including 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
LIMITS OF LIABILITY: Under Section II - 1(i) of the Policy - Death or bodily injury such amount as is necessary to meet the requirements of the Motor Vehicle Act, 1988. Under Section II - 1(ii) of the
Policy - Damage to Third Party Property - Rs.7,50,000.00 P.A. Cover for the Owner cum Driver Under Section III (CSI)- Rs.15,00,000.00

Warranties: It is hereby warranted the coverage under this Policy commences only from the Risk Start time and Date as mentioned in the Policy schedule. No Liability shall attach under this Policy in
respect of any Accident/Loss prior to the time and date of commencement of Period of Insurance.
Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy. If the information be found incorrect or false in any aspect, this Policy
shall be void ab initio and no benefit shall be payable by the company No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
As per GR36 A, PA for Owner-driver refers to the Owner of the Insured Vehicle holding an effective driving license.
It is Warranted that the vehicle should possess a valid POLLUTION UNDER CONTROL certificate during the policy period, failing which assessment of own damage claims will be repudiated. Coverage
under this policy is subject to realisation of premium cheque(s). In case of dishonor of cheque(s), no separate intimation will be given and the policy stands cancelled from inception.

NOTE: The Policy Schedule CUM Certificate of Insurance is an important document issued based on your declaration. We request you to verify the details and ensure that everything is in order. In case
of any discrepancies, please contact us within 15 days from the date of issuance of policy.

Intermediary Name : Quickinsure Insurance Brokers Private Limited

Code : 201860013807 Contact No :9975570811

Business Location : Chennai Head Office

GST Invoice No :3379/03587004/000/00 GSTIN : 33AABCC6633K1ZQ SAC Code:

997134 SAC Description: Motor Vehicle Insurance Services

for Cholamandalam MS General Insurance Company Limited,

Place : Chennai Date : 02/08/2023

Duly Constituted Attorney(s)

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 the Motor Vehicles
Act, 1988.

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 hold good

Whether tax is payable under reverse charge basis – No

Refer our website for Policy Wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list. Call Toll Free: 1800 208 5544 SMS CHOLA to 56677 |
Visit www.cholainsurance.com | Email [email protected]. Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services
offered. To opt out from the facility, please register under Do Not Call section on our website.