THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Commercial Vehicle Package Policy

UIN Number - IRDAN190RP0044V01100001

Policy Number :62060831220100000598

POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
UNGUTURU MICRO OFFICE (620608), NAME: DI_UNGUTURU MICRO OFFICE - UNGUTURU MICRO OFFICE (620608)
D.NO.1-194, UPSTAIRS OF M/S.UNION BANK (DI620608) OR
OF INDIA, NH ROAD, UNGUTURU , , , Mrs. Y Visalakshi - (), CUSTOMER CARE NUMBER: 1800-209-1415
ANDHRA PRADESH , 534411. PHONE NUMBER: / / 9010233677
PHONE NUMBER:08818252007 / 9948132666 LAND/FAX NUMBER:/
FAX NUMBER:NA / NA EMAIL:[email protected] /
Email:[email protected]

INSURED DETAILS
Insured's Name AVULA PHANI BABU Customer ID POA3363019 (PAN No :NA)
Insured's Address S/O.VEERA RAHAVA RAO,D.NO.20/374,CHILAKALAPUDI Contact Number / / XXXXXX0022
VILLAGE,
MACHILIPATNAM ,ANDHRA PRADESH, 521001
Email
GSTIN NA

POLICY DETAILS
Period of cover 17/02/2023 10:00:28 PM to 16/02/2024 11:59:59 PM Receipt Number 62060881220000000906 -
17/02/23
Previous Insurer UNITED INDIA INSURANCE CO. LTD. Previous Policy Number 1707013121P111864593
VEHICLE DETAILS
Geographical Area / Zone: India/C Year of manufacture: 2012
Type of Commercial C - Passenger Carrying Sub Type: C2-Four Wheeler(Carrying
Vehicles: >6)
Name of the Financier: SAKTHI FINANCE LTD Chassis no./Engine no.: MB1PREJC4CEPJ8547/CPE
Z416741
Type of fuel: Diesel Cubic capacity ( cc): 5759
Type of body: Bus Gross Vehicle Weight 0
(GVW):
Make/Model: ASHOK LEYL/ALPSV 4/169 Registration no. TN-52-W-9959
Seating capacity including 45 Variant: 45 Seater
Driver:
Automobile Association Colour: OTHERS
membership:
Cover Note No/Cover / Name of registration TAMIL NADU
Note Issue Date: authority:
FASTag ID:

INSURED DECLARED VALUE (Rs)

Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
1600000 0 0 0 0 1600000

SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 5675 Basic TP Premium 14343
(+)Loading for Additional Towing Coverage 1500 (+)Add Legal liability to passangers 29818
(+)LL to paid driver conductor cleaner employed for
oprn 150
Calculated OD Premium 7175 Calculated TP Premium 44311
Total OD Premium (Rs) 7175 Total TP Premium (Rs) 44311
Signature Not
Verified
Digitally signed
by JAGATJAYEE Policy No. : 62060831220100000598Document generated by 25687 at 2023/02/17 22:09:59.
PANIGRAHI
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2023.02.17
22:09:59 IST Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.

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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Net Premium (Rs) 51,486

GST (Rs) 9,268
Total Payable (Rs) 60,754
Total Payable in Rs(in words): RUPEES SIXTY THOUSAND SEVEN HUNDRED FIFTY-FOUR ONLY
GSTIN(Issuing Office) 37AAACN4165C2ZP
SAC 997134 (Motor vehicle insurance services)
Limitation as to use:The Policy covers use 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 a) Organised racing b) Pace Making c)
Reliability Trials d) Speed Testing e) Use whilst drawing a trailer except the towing (other than for reward) of any one disabled Mechanically
propelled vehicle.
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 7,50,000
For individual covers (OD) in RS:1600000 Compulsory excess in Rs:1500
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive:Any person including the 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 requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
PA cover for Owner Driver
Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
none 0 none NA NA
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
NA NA NA NA
Premium and GST Details
Rate of Tax Amount in INR

Premium Rs 51,486
SGST 9 4634
CGST 9 4634
IGST 0 0

In witness where of this policy has been signed at UNGUTURU MICRO OFFICE on this 17/02/2023
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to Package/Liability policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,40.
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 Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company website.
I/We hereby certify that the policy to which this Certificate For and on behalf of The New India Assurance Company Limited
relates as well as this Certificate of Insurance are issued in
accordance with the provisions of Chapter X and XI of M.V. Act,
1988.
Date of Issue: 17/02/2023

Duly Constituted Attorney(s)

Policy No. : 62060831220100000598Document generated by 25687 at 2023/02/17 22:09:59.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.

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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

IRDA Registration Number: 190

NIA PAN NUMBER: AAACN4165C

Policy No. : 62060831220100000598Document generated by 25687 at 2023/02/17 22:09:59.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.

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