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Mr. Rajiv Khanna

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21-a,Green Avenue,Amritsar,Punjab,,143001
9815398048

Subject : Reliance Householders' Package Policy Schedule Policy No : 2003262613000533

Dear Mr. Rajiv Khanna
Welcome to the Reliance General Insurance family!

We are delighted to have you as our valuable customer and are truly thankful that you have chosen Reliance General Insurance for your
Insurance requirements.

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We are pleased to inform you that you have been insured under Policy No. 2003262613000533 Attached herewith your policy document,
with all the details which have been prepared based on the details furnished to us. We request you to kindly go through the same.

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For any discrepancy in the document, kindly write to us within 15 days for necessary rectification. In the absence of any communication from
your end, the contents and coverage of the policy shall stand accepted by you.
To enable us to serve you better, you are requested to mention your Policy Number in all your further correspondences

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With Reliance General Insurance, you get nothing less than excellent and unparalleled services.
Thanking you once again for choosing us. Look forward to a long lasting and delightful relationship.
Yours sincerely,

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For Reliance General Insurance Company Limited

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Authorized Signatory

An ISO 9001:2008 Certified Company

Registered Office: 19, Reliance Centre, Walchand Hirachand Marg, Ballard Estate, Mumbai 400001.Corporate Office: Reliance Centre, South Wing, 4th Floor, Off.
Western Express Highway , Santacruz (East), Mumbai - 400 055.
UIN No.: IRDA/NL/F&U/RGI/WC
PAN No: AABCR6747B
Corporate Identity No.U66603MH2000PLC128300. RGI/MCOM/MI-01/POLICY-SCHEDULE/Ver. 1.0/110615
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License

Reliance General Insurance Company Limited. IRDAI Registration No. 103.

Digitally signed by
Mr.Anand Singhi
Date: 2016.08.31
11:32:48 IST

OPTION-A & PLANA3

Householders' Package Policy Schedule

Cover Note/Proposal No : R30081616869

Name of the Insured :

Mr. Rajiv Khanna

Period of Insurance :
From: 30/08/2016 To: 29/08/2017

Address of the Insured :

21-a,Green Avenue,Amritsar,Punjab,,143001

Policy issuing branch :

Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway ,
Santacruz (East), Mumbai - 400 055.

Contact No : 9815398048

Date of proposal & declaration :

Location of Insured Premises :

21-a,Green Avenue,Temple Lane,Amritsar,Punjab,143001

Insured's business/occupation :

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Policy Number : 2003262613000533

30/08/2016

Policy Servicing Branch Office :

Eminant Mall, 3rd Floor, 10- The Mall, Amritsar, Punjab

Businessman/Industrialist Medium Scale

Branch Code : 2003

Premium Details (`)

Plan Cover Details

Sum Insured (`)

Cover Details
Fire and Allied Perils Contents excluding terrorism

500000.00
500000.00

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Burglary and House Breaking including Larceny or Theft

Domestic Mechanical and Electrical Appliances

150000.00

TV or DVD or VCD Player

Net Premium
Service Tax (14% of Net Premium)
Swachh Bharat Cess (0.5% of Net Premium)

1423.00
199.22
7.12

Krishi Kalyan Cess (0.5% of Net Premium)

Total Premium

7.12

(`)

1636.00

70000.00

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Sectionwise Excess: As per company policy wordings

199.22

0.00

Service Tax Reg. No. : AABCR6747BST001 Category-General Insurance Business Service 00440005
Consolidated Stamp duty Paid vide GRAS GRN No. MH001675469201617E dated 09 June 2016** ** Not Applicable for the State of Jammu & Kashmir

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Intermediary Code/Name

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16A31114/Vansham Aggarwal

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This policy provides you with a host of HomeAssist services at no extra cost. The HomeAssist team assists you with Electric Gadgets Repair
assistance, Plumbing/Carpentry Assistance, Telephone Medical Attention, Pest Control Services IT return assessment and filing, hotel/restaurant
information and reservations, moving from one house to another, flower/gift deliveries and couriers.

Intermediary Contact No.

Intermediary E-mail ID

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Remember to carefully go through the policy documents and confirm your details.
This Policy has been prepared based on the information furnished to us and we request you to kindly go through the same. Information received from you has been
specified in the Policy document on the basis of understanding provided to the Company

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If you find any discrepancy in the document,kindly revert on 1800 3009 (toll free) or visit any of our branches or mail us at rgicl.services@relianceada.com for
necessary rectification forthwith but in no case later than 15 days from the date of receipt of the Policy document .In the absence of any communication from your
end, the contents of the policy shall stand accepted by you.
Kindly refer to the Customer Information Sheet and Policy Wording to understand your policy better and learn more about the policy coverages &
Policy Exclusion.

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Note: Claim, if any may be intimated to our call center 1800 3009 (toll free) within 24 hours. Delay in intimation may result in violation of policy condition.
The content on this page is for additional information & should not be considered as part of the policy document / certificate.

Reliance General Insurance Company Limited.IRDAI Registration No. 103.

An ISO 9001:2008 Certified Company

Registered Office: 19, Reliance Centre, Walchand Hirachand Marg, Ballard Estate, Mumbai 400001.
Corporate Office: Reliance Centre, South Wing,4th Floor, Off. Western Express Highway, Santacruz (East), Mumbai - 400 055.
UIN No.: 46/IRDA/HLT/RGI/NL-PACKAGE/2015-16, IRDA/RGICL/HHP/39/2006.
PAN No: AABCR6747B
Corporate Identity No.U66603MH2000PLC128300. RGI/MCOM/MI-25/POLICY-SCHEDULE/Ver. 1.0/051215
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.

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Warranties and Special Conditions if any

Basis of Valuation shall be as below: Reinstatement Value (RV) basis: a) Fire and Allied perils b) Burglary & Housebreaking c) Fixed Plate Glass d) Neon
Sign/Glow Sign/Hoarding. Cost and Net Replacement Value (CNRV) basis a) Electronic Appliances b) Electrical and Mechanical Breakdown

Claim against obsolete / upgraded machines under Domestic Mechanical & Electrical Appliances / Domestic Electronic Appliances section shall attract pro-rata
improvement / depreciation as per respective Domestic Mechanical & Electrical Appliances / Domestic Electronic Appliances terms & conditions.

In the event of a claim, the onus and responsibility of proving insurable interest and providing necessary documentation lies on the Insured.

It is warranted that all equipment covered under Domestic Electrical & Mechanical Appliances, TV / DVD & Electronic Equipment Section are not more than 10
years old.

Policy does not cover Portable Electronic Equipment of any type

This policy excludes cover in respect of any building/structures and contents therein, falling under Kutcha Construction"

Under Fixed Plate Glass Section only fixed or framed glasses are covered.

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Note: In the event of dishonor of the cheque, this policy document automatically stands cancelled from inception, irrespective of whether a separate
communication is sent or not.
"The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject
otherwise to the terms, conditions and exclusions of the Householder's Package Policy"
In witness whereof this policy has been signed at Mumbai on .30/08/2016 In case of any assistance with claims, please contact us on
or email us at 1800 3009 (toll free) rgicl.services@relianceada.com
For Reliance General Insurance Co. Ltd

Authorised Signatory

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21-a,Green Avenue,Amritsar,,143001

Reliance General Insurance Company Limited.IRDAI Registration No. 103.

An ISO 9001:2008 Certified Company

Registered Office: 19, Reliance Centre, Walchand Hirachand Marg, Ballard Estate, Mumbai 400001.
Corporate Office: Reliance Centre, South Wing,4th Floor, Off. Western Express Highway, Santacruz (East), Mumbai - 400 055.
UIN No.: 46/IRDA/HLT/RGI/NL-PACKAGE/2015-16, IRDA/RGICL/HHP/39/2006.
PAN No: AABCR6747B
Corporate Identity No.U66603MH2000PLC128300. RGI/MCOM/MI-25/POLICY-SCHEDULE/Ver. 1.0/051215
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.