Agent Name Policybazaar Insurance Wa PVT LTD Agent Code Imd1046412 Agent Contact No 8800556374
Agent Name Policybazaar Insurance Wa PVT LTD Agent Code Imd1046412 Agent Contact No 8800556374
Agent Name Policybazaar Insurance Wa PVT LTD Agent Code Imd1046412 Agent Contact No 8800556374
TOTAL OWN-DAMAGE PREMIUM (A) 17,275.64 TOTAL LIABILITY PREMIUM (B) 9,534.00
Roadside Assistance IRDAN150RP0004V01201819/A0026V01201819 249.00 PA Owner Driver (1 Year From Date of Inception) 375.00
TOTAL ADD-ON COVER PREMIUM (C) 249.00 Net Premium(A+B+C+D) Taxable Value 27,434.00
Name of the Nominee Relationship with Insured Name of Appointee (if nominee is minor) Relationship with the Nominee
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 M.V. Act, 1988.
In witness whereof this Policy has been signed at Mumbai on 21/10/2021
Receipt No: 10210000021100061689
In case of Claims, Please contact us at : Toll Free No - 18002665844,
email id - [email protected]
Date of Issue : 21/10/2021
Place : Mumbai
Consolidated Stamp duty has been paid as per letter of Authorization no. For Liberty General Insurance Limited
CSD/305/2021/1234 Dated 26/03/2021 issued by Main Stamp Office, Mumbai. ** Not
Applicable for the State of Jammu & Kashmir.
Invoice No. 2721011000530032
Branch GSTIN No : 27AABCL9950A1ZL
SAC Code : 997134; Description of Service : General
Insurance Service; Place of Supply : UTTAR PRADESH/09
IRDA Regn. No. 150
CIN No. U66000MH2010PLC209656
Tax is not payable under reverse charge by the recipient Authorised Signatory
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
% DSUnknown
q
1G
1g
0.1 0 0 0.1 9 0 cm
0 J 0 j 4 M []0 d
1i
0g
313 292 m
313 404 325 453 432 529 c
478 561 504 597 504 645 c
504 736 440 760 391 760 c
286 760 271 681 265 626 c
265 625 l
100 625 l
100 828 253 898 381 898 c
451 898 679 878 679 650 c
679 555 628 499 538 435 c
488 399 467 376 467 292 c
313 292 l
h
308 214 170 -164 re
f
0.44 G
1.2 w
1 1 0.4 rg
287 318 m
287 430 299 479 406 555 c
451 587 478 623 478 671 c
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
478 762 414 786 365 786 c
260 786 245 707 239 652 c
239 651 l
74 651 l
74 854 227 924 355 924 c
425 924 653 904 653 676 c
653 581 602 525 512 461 c
462 425 441 402 441 318 c
287 318 l
h
282 240 170 -164 re
B
Q
RIGHT OF RECOVERY". For legal interpretation English version will be good. Digitally signed by: SACHIN JOSHI
Date: 2021-10-21 13:54:24 IST