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Certificate Cum Policy Schedule: Gccv-Public Carriers Other Than Three Wheelers Package Policy - Zone C

This document is a certificate of insurance and policy schedule for a commercial vehicle. It provides coverage from August 14, 2013 to August 13, 2014. The insured vehicle is a 2010 Tata Motors Ace STD registered in Tamil Nadu. Coverage includes own damage, third party liability, and personal accident coverage for the owner-driver. The document also lists policy premium amounts, insured declarations, and limitations of coverage. It was issued by Shriram General Insurance Company Ltd on August 2, 2013.

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174 views1 page

Certificate Cum Policy Schedule: Gccv-Public Carriers Other Than Three Wheelers Package Policy - Zone C

This document is a certificate of insurance and policy schedule for a commercial vehicle. It provides coverage from August 14, 2013 to August 13, 2014. The insured vehicle is a 2010 Tata Motors Ace STD registered in Tamil Nadu. Coverage includes own damage, third party liability, and personal accident coverage for the owner-driver. The document also lists policy premium amounts, insured declarations, and limitations of coverage. It was issued by Shriram General Insurance Company Ltd on August 2, 2013.

Uploaded by

Anand S
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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CERTIFICATE CUM POLICY SCHEDULE

GCCV-PUBLIC CARRIERS OTHER THAN THREE WHEELERS PACKAGE POLICY - ZONE C


Issue Office: 10003 - Address:- E - 8, RIICO INDUSTRIAL AREA SITA PURA -JAIPUR RAJASTHAN 302022 Tel
Policy No : 10003/31/14/294636 Prev Policy No - Geographical Area
Insured's Code/ Name: 6753108 PONNUCHAMY
Address: NO 147 POONGA STREET,POOMPOZHIL NAGAR,AVADI CHENNAI - TAMIL NADU
Tel PADI MAIN BRANCH Fax CENIO208230005
Executive: NA0000000256 Broker Details :LC0000000002 M/S.R S I B P Ltd. Contact No:
Period of Insurance : From 00:00 on 14/08/2013 To Midnight of 13/08/2014 Cvr Note No. - Issue date
Gross Premium: 15,320 S Tax: 1,894 GST:0 Total: 17,214 Collection No & Dt BG

Registration Engine No Make - Model Type of Body Cubic Seat Cap


Date Of Regn /
Capacity/
Mark & Place Chassis No Year of Manf G. V. W Delivery (IncL Driver)
TN 25 Q 4365 275LD106KZYSF6697 TATA MOTORS LTD-ACE (STD) STD 700 1550 15-07-10 1+1
Thiruvannamalai MAT445056AZK75964 2010
Trailer Registration No. :

IDV For the IDV For Non Electrical Electrical CNG KIT SI Total Value
Vehicle Trailers Accessories Accessories
1,80,000 0 0 1,80,000

SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
BASIC OD COVER BASIC TP COVER 3,107.00 13,082.00
LESS :DETARIFF DISCOUNT ON BASIC OD ADD :GR36A-PA FOR OWNER DRIVER 621.00 100.00
LESS :NO CLAIM BONUS-GR27 497.00
ADD :LL TO PAID CLEANER COUNT : 2 100.00
OD TOTAL 1,988.00
ADD :LL TO PAID DRIVER COUNT : 1 50.00
TP TOTAL 13,332.00
TOTAL PREMIUM 15,320.00
ADD :SERVICE TAX 1,894.00
TOTAL AMOUNT 17,214.00
* NCB discount - 20 % Previous Policy : 71240331120100011445 - Previous Insurer : NEW INDIA ASSURANCE COMPANY
Nominee for Owner/Driver : NA- Age : NA - Relationship : NA - Appointee Name : NA - Appointee Relationship : NA
Deductibles under Section-I : Compulsory Deductible Rs.500
Subject to IMT Endorsement Printed herein/attached to : IMT-40 , IMT-28 , IMT-39 , IMT-21
Hypothecation Agreement with: SHRIRAM TRANSPORT FINANCE CO LTD, PADI MAIN BRANCH, CHENNAI, CENIO208230005, Pin Code - -

Hire Purchase/Lease Agreement with: -


Limit of Liability
Under Section II-1(i) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-1(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 Owner - Driver (CSI) : Rs. 200000
Driver's 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 when not used for the transport of goods at
the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limitations as to Use
Use only for carriage of goods within the meaning of the Motor Vehicles Act. The Policy does not cover: 1) Use for organised racing, pace-making, reliability trial or
speed testing. (2) Use whilst drawing a trailer except the towing (other than for reward) of any one disabled mechanically propelled vehicle. (3) Use for carrying
passengers in the vehicles; except employees (other than the driver) not exceeding the number permitted in the registration document and coming under the
purview of Workmen's Compensation Act 1923.
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 insurance under this policy is subject to conditions, clauses, warranties, endorsements as per forms attached.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). 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 Head Office - III on 02-AUG-13

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 isrecoverable from the Insured. See the Clause headed "AVOIDANCE OF
CERTAIN TERMS AND RIGHTS OF RECOVERY".

POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.
Preinspection Report: Not Applicable
Note: In case of new vehicle, Insured have to submit registration documents within a period of 15 days from the date of issue of Registration Certificate of Vehicle.

For and on behalf of


SHRIRAM GENERAL INSURANCE COMPANY LTD

Place : JAIPUR Date : 02/08/2013

We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the expiry date of your
policy. If you do not want us to contact you, kindly send an e-mail for the same on [email protected]
Consolidated stamp Duty paid vide Inspector General Registration and Stamp Ajmer order No. F-7(84) Gen/11/27550 dated 21-11-11.
All the Amounts mentioned in this policy are in Indian Rupees Note :- Claim intimation after 48 hours will be Authorised Signatory
Service Tax Reg. No. AAKCS2509KST001 considered as delayed intimation. Page 1 of 1

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