To authenticate your policy:

1. visit https://scan.me/download Digitally signed by

2. Download the QR code scanning app Mr.Anand Singhi
3. Scan the QR code on this policy and be Date: 2017.03.07
assured that you have an original policy
SID030717058386

http://rgiclser Reliance Two Wheeler Certificate cum Liability Policy Schedule

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0Policy Number : 1105272348010111 Proposal/Covernote No : R07031918535

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Insured Name : Period of Insurance:

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M/S RASHMI C THADESHWAR From 00:01 Hrs on 10-July-2019 to 23:59 Hrs of 09-July-2020

Communication Address : Policy Issuing Branch :

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RM NO 06 NONGHA BHARWAD CHAWL, 4TH FLOOR,CHINTAMANI AVENUE,NEXT TO VIRVANI INDUSTRIAL
R.T RD, DAHISAR (E), ESTATE,OFFWESTERN EXPRESS HIGHWAY,GOREGAON
MUMBAI, MAHARASHTRA, EAST,MUMBAI-400063 MAHARASHTRA
INDIA, 400069 FINA

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Mobile No : NA Email-ID :KRANTI
NA AGARDU

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Nominee Name: Hypothecation/Lease :
NA

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Insured Vehicle Details

Registration No. MH02BE2115 Mfg. Month & Year NOV-2007

Hero Motocorp/Pleasure/ Std

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Make / Model
CC / HP 102

Engine No./Chassis No. 07L1AM00131 / 07L1BC00223 Seating Capacity of side car (if any) including driver 2
Type of Body/LCC NA e Total Premium ` 828.00

RTO Location MAHARASHTRA - Mumbai Western Suburbs-Andheri Total IDV ` NA

West
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Insured Declared Value (IDV)
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Vehicle ` 0.00 Trailer ` 0.00

Electrical / Electronic Accessories ` 0.00 Total Cover SI ` 0.0
Non Electrical Accessories ` 0.00 Total IDV ` NA
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Premium Summary 2348

Own Damage Amount (`) 0 II

Liability - Section Amount (`)
Basic OD 0.00 Basic Liability (TPPD 2) 0 619.00
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Less: Restricted Third Party Property Damage 0

to Rs6000/-( IMT - 20) 0 -50.00
Total Basic Liability Premium 1 569.00
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PA Benefits - Section III 1

TOTAL LIABILITY PREMIUM 1 569.00
TOTAL PACKAGE PREMIUM (Sec I + II + III) 1 569.00
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Add: Service Tax (14 % of Net Premium) 0 79.66

Add: Swachh Bharat Cess (0.50 % of Net Premium) 0 2.84
Add: Krishi Kalyan Cess (0.50 % of Net Premium) 0 2.84
TOTAL PREMIUM PAYABLE (`)
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828.00
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Subject to I.M.T.Endt.Nos. IMT 20 Service Tax Registration No. AABCR6747BST001

Category-General Insurance Business : Service 00440005
Limits of liability :
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(a) Under Section II (1)(i) of the Policy-Death of or bodily injury to any person so far as it is necessary to meet the
requirements of the Motor Vehicle Act, 1988. (b) Under Section II (1)(ii) of the Policy-Damage to property other than property
belonging to the insured or held in trust or in the custody or control of the insured up to the limits specified- (TPPD 1 Sum
Insured - ` 1,00,000/-, TPPD 2 Sum Insured - ` 6000/-). (iii) PA cover for owner-driver under section III CSI ` 0.0/-
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Limitations as to use : The Policy covers use 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) Any purpose in connection with
Motor Trade
Persons/Classes of persons : Any person including the Insured provided that a person driving holds a valid driving license at the time of the accident and is
entitled to drive not disqualified from holding or obtaining such a license. Provided that the person holding a valid Learner's License may
drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.

17A34144/Suraj Tiwari 9930267668 [email protected]

Intermediary Code/Name Intermediary Contact No. Intermediary E-mail ID

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 Special Conditions : NA

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"It is hereby declared and agreed that all pre-existing damages to the vehicle having occurred prior to the commencement of cover are excluded from the scope of the
policy."

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The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.co.in
Consolidated Stamp duty Paid vide GRAS GRN No. MH007955580201617E dated 25 January 2017** ** Not Applicable for the State of Jammu & Kashmir

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Statutory Provisions:
"As per Section 146 of the Motor Vehicle Act, 1988 it is Mandatory to have your vehicle insured against third party risk.
As per section 196 of the above act, driving a vehicle without valid insurance is punishable with fine up to ` 1,000/-or imprisonment up to 3 months or both."

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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 M.V. Act, 1988. Note: In the event of dishonor of cheque, this policy document automatically stands cancelled from inception irrespective of whether a
separate communication is sent or not.

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No Claim Bonus will be allowed, provided the policy is renewed within 90 days of the expiry of the previous policy.
Safeguard your transaction by paying your premium via crossed cheque/DD in favour of Reliance General Insurance Co. Ltd.
The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject otherwise to the

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terms, conditions and exclusions of the Reliance Two Wheeler Certificate cum Liability Policy Schedule. In witness whereof this Policy has been signed at Mumbai on
policy start date in lieu of Proposal/Covernote No. as mentioned in the policy.
Updating Registration Number of vehicles within 15 days of policy inception is MANDATORY as per IRDA. Kindly provide the same to your Agent/Our Call
centre/Policy issuing Branch (Applicable for policies booked without Registration No of vehicles).
IMPORTANT NOTICE: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment

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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.
Grievance Clause :- For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 1800 3009 or may write
an email at [email protected]. In case the insured is not satisfied with the response of the office, insured may contact the Nodal Grievance Officer of the
Company at [email protected]. In the event of unsatisfactory response from the Nodal Grievance Officer, insured may email to Head Grievance
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Officer at [email protected]. In the event of unsatisfactory response from the Head Grievance Officer, he/she may, subject to vested jurisdiction,
approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company
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website www.reliancegeneral.co.in or on www.gbic.co.in.
Note: Kindly acknowledge the receipt of this policy. In case you find any variations against your proposal or any discrepancy in the policy, kindly contact us
immediately.
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In the unfortunate event of a claim, please call quoting your Policy No. on 1800 3009 (toll free) and register your claim immediately within 7days from the date of loss.
For Customer service, please call along with your Policy No. on 1800 3009 or visit www.reliancegeneral.com
For Reliance General Insurance Co. Ltd.
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Authorised Signatory
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Reliance General Insurance Company Limited. IRDAI Registration No. 103.

Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710.
Corporate Office: Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Santacruz (East), Mumbai - 400 055.
Corporate Identity No.U66603MH2000PLC128300.
Service Tax Registration No. AABCR6747BST001 Category-General Insurance Business : Service 00440005 PAN No: AABCR6747B
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and
used by Reliance General Insurance Company Limited under License. An ISO 9001:2008 Certified Company

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