Go Digit General Insurance Limited Schedule/Certificate

Digit Commercial Vehicle Liability Only Policy

UIN No.: IRDAN158RP0001V01201718

Policy Number D104569318 / 01062023 Issue Date 01-Jun-2023

Period of Policy From 02-Jun-2023 20:13:44 Mobile xxxxxxxxx5055
To 01-Jun-2024 23:59:59 Email [email protected]
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CGST GSTIN Unregistered GST State Code 27
29. Name SHUBHAM KAILAS BORSE Partner Code 1141894
PLOT NO 1 BHADGAON ROAD Partner Name PRIYA ABHAY KOTHARI
263 OMKARESHWAR NAGAR POST POCHORA
Ha Address
JALGAON JALGAON MAHARASH,TRA
Partner Contact 9922112468
lf 424201,Jalgaon-424101 Partner Email [email protected]
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ck PAN (POSP) BFFPS6372N
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Registration, Make Policy Type CubicCapacity/Power Registration/ Trailer Reg.
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G80 Model IMT Endorsements

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Engine, Fuel Type GVW Manufacturing No.

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Chassis No. Variant Body Type Licensed Capacity Year

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BFF Public

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MH46BF5718 TATA 5883 CC 2018
POS Carrier

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N 81B84458095 LPK 2518 Diesel 28500 Kg

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IMT-28

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Half deck

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MAT448854JAC open metal --

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CRE 10X20 TIPPER 2 1

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05300 body (OEM

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Built)

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Premium Details
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Third Party Liability Premium (`) 43950.00
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KH PA cover for Owner-Driver Premium (`) D
330.00
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Age Legal Liability for Paid Driver (Persons:1)(`) 50.00 0

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Net Premium ` 44330.00

501
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15000 CGST @ 9% = (`34.20) + SGST/UTGST @ 9% = (`34.20) ` 68.40

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43950
Dies CGST @ 6% = (`2637.00 ) + SGST/UTGST @ 6% = (`2637.00)
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` 5274.00
-0
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Total Premium ` 49672.40

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I/We hereby affirmatively warrant/declare that the vehicle body-type is declared accurately and correctly. I/we further understand and acknowledge
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that, if the body-type is found to be other than what has been declared, shall amount to misrepresentation and Insurer shall have the right to cancel
the policy and/or reject any claim in accordance with policy terms and conditions and express clause attached on this policy.
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0 ENDORSEMENT
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330
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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium
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CGST IA097552330 2023-06-01 44330.00 0.00 2671.20 2671.20 0.00 0.00 49672.40
57

Goods
BF

IA109305481 2023-09-27 0.00 0.00 0.00 0.00 0.00 0.00 0.00

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Nominee Details
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Previous Insurer Policy Exp.

Name: -- Policy Number: -- Date: --
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Die Other Details

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Odometer 0
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FASTag Number 0
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02/0 Financier Details

Receipt Details
Receipt No.
Invoice No. IA109305481
Receipt Date
Invoice Date 27-Sep-2023

PolicyNumber :-D104569318
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 Go Digit General Insurance Limited Schedule/Certificate
Digit Commercial Vehicle Liability Only Policy
UIN No.: IRDAN158RP0001V01201718

Geographical Area - Any accidental loss damage and/or liability caused sustained or incurred within India shall be covered subject to Policy Terms and
Conditions, unless specifically agreed and endorsed. Limitation as to use - The policy covers use of the vehicle only under a permit within the meaning of the
Motor Vehicles 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
Organised racing, Pace Making, Reliability Trials, Speed Testing, Use whilst drawing a trailer except the towing (other than for reward) of any one disabled
Mechanically propelled vehicle (only for Passenger Carrying Vehicle). Person or class of persons entitled to drive - Any person including the insured 1)
Provided that a person driving holds an valid and effective driving license at the time of the accident and is not disqualified from holding or obtaining such a
license. 2) Provided also that the person holding an vaild and 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 and any subsequent amendment as applicable. Limits of Liability - Under Section II - 1 (i)
of the policy - Death of or bodily injury: such amount is necessary to meet the requirements of Motor Vehicle Act, 1988 and any subsequent amendment as
applicable Under Section II - 1 (ii) of the policy - Damage to Third Party Property ` 750000 P.A. Cover under Section IV for Owner - Driver (CSI): ` 1500000
Important Notice : 1) *Cheque dishonor / Non-receipt of payment: If premium paid through Cheque, the policy is void ab initio in case of dishonor or non-
receipt of payment. 2) Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of Chapter X and Chapter XI of MV act, 1988
subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 3) This policy is subject to the standard policy
wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff 4) Policy would be void on the ground that it was obtained

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by non- disclosure of material fact or by a representation of fact which was false in some material particular. 5) The insured is not indemnified if the vehicle is

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used or driven otherwise than in accordance with this Schedule. Any payment made by Company for reason of wider terms appearing in Certificate in order

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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). in
the policy.

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PUC Declaration:The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of
commencement of the Policy.

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For & On Behalf of Go Digit General Insurance Ltd.

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Consolidated Stamp Duty has been paid as per Letter

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of Authorization No.67-B/04/2017-18 Date: 30th May

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Authorized Signatory 2017 issued by Department of Stamps and

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Praveen Bhat Registration , Bengaluru- 560009 - KARNATAKA.

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Senior Vice President - Customer Experience HSN: 997134/General Insurance Services In

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[email protected]
Hey, our document is now digitally signed

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Printed, Signed, and Executed at Bengaluru
Click here to view the certificate.

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For instant resolution, you can ping us “Hi”

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on WhatsApp at 702 606 1234

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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. A
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Company incorporated under Indian Companies Act, 2013 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Reg No.
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158, Corporate Identification Number U66010PN2016PLC167410 | GST Reg. No.: 27AACCO4128Q1Z0 GSTIN Address: Nasik Business Centre,Office No
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301, 3rd Floor, B-Square, College Road,Nashik,Maharashtra,PIN-422005

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In case of claim or any other query, please contact our 24-hour Call Centre at 1800-258-5956 or email us at [email protected] or visit our website
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www.godigit.com.
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PolicyNumber :-D104569318
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