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Page | of 3 1c1ct Lombard ‘Two Wheeler Package Policy ice eee CERTIFICATE CUM POLICY SCHEDULE ae aban ae ss eT For instant renewal nw Www.icicilombard.com ‘ustomersuppert@icclombard.com certificate cum Polley No : 3005/2010812114/0000000286 Tesuing Office TIcicl LOMBARD HOUSE 414, Veer Svaviar Wang, Near SUGn Vinayak Temple, rebbadev Hunn a00025 cation Franiunapu [Period of Insurance [From 19:07 09/04/2015 To 08/04/2016 midnight notes ICHENNAT, intermediary Code fissured name exeNoTRANT Policy esued On ooy0072035 earn fro 16 320 CROSS STREET GANESH TUCGAR RAGIPAKEAR aan ernie CHENNAI, TAMIL NADU, Pin — 600091 eee Oey Primary vertical Name Joa CASSORANCE-Notar Two Wheeler fessor contact no p-9745050132{ Hobie Ro megeewatior | hake Modi | cc ie [S2t| chassis number [Engine number Veticle Tow | Side Cor | Adaional Ace | NonElecirical Ace | lecirieal/rectronie Ace [ewG/uPG Unit Toi valve eran 2 7 2 2 z S70 SCHEDULE OF PAEMTUN ‘own Damage( asc Tha party aby 320,00 PA Cover For Owner-Drver Of Rs. 100000 0.00 unnamed PA Caver of Rs. 200000 For uo ces Bonus (NCB), Coverages ond endl Keceved you" tiny writn to ue at he below mentiones maiing adress [Compulsory Deductibies + Rs 100 Iainits OF Liability + (e)Under Section lt () of We policy >Death of o badly injury: Such amount as necessary to meet there requirements ofthe Motor Weneies act,1988,(0)under Section TI {ot tne poly» Damage to Third Party Property Rs 100000.00; PA Cover for Onner-Driver under section I: SI [ts '100000.00 voluntary Deduetable REO [IMITATIONS AS TO USE: The policy covers Use Of We velice for any purpose other than = Hie or reward, Carroge of gpods(other than samples of personal ggage), Organized racing, Pace making, Speed testing, Relbily rils, Any purpose in connection with Motor Trae. [DRIVER'S CLAUSES: Any person including the insured : Provided tat a person driving holgs an effective Driving License atthe ime of the accident and ot disqualified from holing or obtaining sues lcense. Provided algo thatthe person hoidng an effective Learner's Leense may also drive the vehicle and nat such person sates the requicements of Rule 3-of the Central Motor Vehicles Rules, 1989. EMPORTANT NOTICE : The Insured snot mdemnfeg Ifthe vehicle is used or driven otherwise than in accordance with tis Schedule, Any payment made by ine company by reason of wider terms appearing In the Cerecate in order to comply with the Motor Vehicle Ac, 1988 is recoverable trom the Insure. S Ine cause heeded “AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY". For legal interpretation English version wit hold good. [Subject to INT Endorsement Nos. & Memorandum printed herein / attached hereto; 22,28 [Premium collection Detail Nive hereby ceri thatthe polcy to which the certificate relates as well asthe certifeate of Insurance are issued in accordance with the provision of chapter xt of Mv.Act 1988, is vald subject to Reslaation of Cheque: [grievance Clause: [For resoiton of any query or grievance, Insured may contact the respective branch office ofthe Company or may cal tol fee no.1800-26660r may approach us a the sub section “Grievance Redreszal on our website vow cclombard.com (Customer Suppert sector). However, ithe resakton provides By.us is ot satisfactory you may approach Insurance Regulatory and Development Authary (IRDA) trough the Integrates Grievance Management Section [lchs) or IRDA Grievance Cal Cenre({GCC) at ther tl free n.155255. You may alsa approach Insurance Ombudsman, sublect fo vested jurslton, for ine regeesal ot guevance, Detasof Insurance Ombudsman offices are avaliadle at IRDA website: wm. ldaindia.er, 9 on the Company's website wv ombard eam ‘The stamp duty of Re 0:5 paid in cash or by demand draft or by ayorder de receiptJehallan 43201 dated 19/03/2015 ‘Service Tax Registration No. : GIS / MUMBAI-I / 1528 / 2001 ‘Service Tax Code Number. :AAACI7S04GSTO0 Category: General Insurance Business Services 00440005. uly constituted Attorney(s) COPY OF POLICY CHET Lombard General Insurance Company std Mailing Add. Office: ICICT LOMBARD HOUSE, 414, Veer Savarkar Marg, Wear Siidhi Vinayak Temple, Prabhadevi, Mumbat 400025. Corporate Office: ICICI LOMBARD HOUSE, 414, Veer Savariar Marg, Near Siddhi Vinayak Temple, Prabhedevl, Mumbai 400025.