11/13/24, 5:39 PM HIBIPL - Policy Details

Prev. Policy No:

39010231246200322689

Insured Business/Profession Address of The Insured TP Valid From TP Valid To

W/O RAMESH GRAM KHAIRAI TEH RAGHOGARH Guna MADHYA 13-11-2024 Midnight of 12-
Ms PREM BAI Self Employed
PRADESH 473226 , Mobile No XXXXXX2938 17:39:32 11-2029
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg Cubic Capacity GSTIN No. (Customer)
Hero MotoCorp
New HA11E7R4J17088 MBLHAW212R4J03161 SPLENDOR+XTEC I3S 2024 100 N/A
DRSC FI
Declared Value Side Car IDV Non-Electrical Accessories IDV Electrical Accessories IDV CNG/LPG/Bi-Fuel Total IDV
(IDV) of Vehicle IDV
76476.00 NA 0.00 0.00 0.00 76476
Place of Regn. Body Type HP/Lease/Hire-Purchase Branch Office of HP/Lease/Hire- Seating Capacity Premium
Agreement With Purchase
Guna Solo SHRIRAM FINANCE LTD., HPA RAGHOGARH 2 5715.00
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 513.00 Basic Third Party Liability : 3851.00
Non-Electrical-Fitting Premium : 0.00 TPPD Discount : 0.00
Electronic & Electrical Accessories : 0.00 Total : 3851.00
Geographical Extension : 0.00 CNG/LPG/Bi-Fuel Kit : 0.00
ND Plus Cover : 184.00 Geographical Extension : 0.00
Less : Add
Handicapped Discount : 0.00 Compulsory PA Cover (Owner Driver) : 295.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
NCB : 0.00 Optional PA Cover(Un Named Driver) : 0.00
Total Own Damage Premium(A) : 697.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 4146.00
Total Premium (A + B) : 4843.00
For any other extra : 0.00
IGST @ 18.00% : 872.00
Gross Premium : 5715.00
1.RegistrationNo.:58||2.LicenceNo.:1424542||3.CNNNo.:U10200WB1906GOI001713||4.GST No.:07AAACN9967E1Z5 ||UIN No.-IRDAN058RP0005V01201819
OD Policy Period 13-11-2024 To 12-11-2025 13-11-2025 To 12-11-2026 13-11-2026 To 12-11-2027 13-11-2027 To 12-11-2028 13-11-2028 To 12-11-2029
IDV 76476 NIL NIL NIL NIL
CPA Rs. 15 lakhs. NIL NIL NIL NIL
DRIVER: Any person including insured: Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified
from Holding or obtaining such a licence.Provided also that the person holding an effective Learner's Licence may also drive the vehicle and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act 1988. Limit of the
amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event : Upto Rs - 100000/
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with the provisions of Chapter X &
XI of M.V. Act 1988
Broker Hero Insurance Broking India Pvt. Ltd. The policy is subject to a compulsory excess of Rs.
Premium of Rs. 5715.00 Received Vide Cash/Cheque CASH 100/- & Depreciation is applicable as per policy
No. terms & conditions* (Please turn overleaf for details)
Dated Nominee Name RAMESH Consolidted Stamp Duty Paid
Drawn on Nominee Age 39 Endorsements: IMT - 22,5
Acknowledgement 13-11-2024 Nominee Relation
Son
Dt
On behalf of NATIONAL INSURANCE
Registration No: 649 Tel No: 1800-102-4376
COMPANY LIMITED
13-Nov-2024
Date & Signature of FOR RENEWALS CONTACT: POS: BRIJESH SAHU, AUTPS3141H Ph.No- 942-5134560
proposer

Dealer's Stamp & Signature Duly Constituted Attorney

# : Received with Thanks Rs 5715.00 from Ms PREM BAI as premium against the money receipt no 024231245224952
Regd. & Head Office : Premises No.18-0374, Plot No. CBD-81, New Town, Kolkata-700156 Service Tax Registration Number - AAACN996EST099
For further information about motor insurance policy please also visit http://irda.gov.in >> Grievances >> Policyholder Handbooks

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