rere / re & safer Fee >ersonal Details of Proposer/Owner: 7 Be nae JALAN TRANS LobisTi es (Proposer's (Owner's) Full Name ANOVA LTD (in Capital Letters) 2 wer (eT omract we aTE WaT TT BN 312) Devitta Tower (fa ats aft) ee ear ‘Address (where the vehicle is normally kept) | Clan dev Nao Gari aba 2 (In Capital letters, with Pin code) 0 3 wBM/Phone: @SYoo2y —fR/PIN: 2o 101) angel /Mobile: 4.94 ‘ha /Fax: ; i 4a E-Mail : 2 3. BER / Aaa Occupation/Business Q@ cya meen. ( Cont com 4, SHAR ST WHT [daar aiftca” cite Type of Cover Liability Policy Only 5. fat waft i . Period of Insurance ). aret & Fae , ) Vehicle Detais $1? >) Dc @ Ranv 0 yal 6. aed Gotreer a. Registration Number of the vehicle ‘arent Totter Bt aT Date of Registration of the Vehicle 7, HAsSSY 0350 | ofrecer srfraseer ye era raft Registering Authority & Location 8 S| 2006 ‘Prater oF Year of Manufacture gon 4. Engine Number. . afee a Chassis Number ‘TEA OT WEIR (eh) Make of the Vehicle ares Pra Vehicle Specifications Zot VRE PBUBNh Asno Tepe 16lg RSet Model ‘atal #1 WOR Type of Body Gre BY STR aA A) Cubic Capacity of the Vehicle (C.C) 201 ( cies 1h2vo lg as* D> 70, Cuble Capacity: 5760 16161L/4 GOVERNMENT OF HARYANA @ CERTIFICATE OF REGISTRATION 4 SS’ (Form No. 23 Rule 48) Resistation No.: HR5S5Y 0350 3 1 | 16. Gross Vehicle Weight : "16200 Kas @imerName —: WS JALAN TRANSLOGISTICS INDIA LD | (@) As Certified by Manufacturer: ther! ‘ ! (b) As Registered : Fai Husband > NOT APPLICABLE 3 | 47.As per Declared by Manufacturer : : Front AX a9 kgg, Rea Axle: ‘taoo kes Add. Prem.) : CHOUDHARY NIHAL SINGH MARKETANH-4 _ § Other Axle 2000 SMtandem Axle: BILASPUR CHOWK GURGAON A ‘Add. (Temp) = CHOUDHARY NIHAL SINGH MARKETNHH BILASPUR CHOWK GURGAON ? HEAVY GOODS VEHICLE le Weight : Rear Axle : Other Axle Tandem Axle : ‘Adtitional Particulars of alternative of Additional Semi-trailer 49 Type of Body : 20.'Unladen Weight : 21. No, Description and Size of tyres on each axle 22. Registered Axle Weight (in tespect of each axle) 23. Hypothecation Lease agreement with 4. Class of Veh. 2.Maker’s Name aSHOK LEYLAND LTO Dealer Name & AGU inact AUTOMOBILES PVT, LTD Name : 3. Type of Body = pOUBLE-OECKED TRANSPORT VEHICL! pee TS ; Previous Detail if any: 4.M.&Y. of Mfg.: 5/2016 Realstration No. on 5.No. of Cylinder’s : ¢ ee: 6. Chassis No. : qg1A3EFOXGPBU3117 7.Engine No. : Gapz2122475 “This Catticate is val rom,_26-SeP-2074,_ Validity of F BiG 13 8.Fuelused — < pIESEL 9. Horse Power: (BHP)ms @ Zz Trusted sine 9 National insurance Gompany | wuted Registered Offcw Address: 3, Mtoean Sau, Hn! Bo Potey waning Office 08-809, Kalash, 26, Kastba Candi Wag, New Ooh Oot Pin TORDT Toe ON NEAT (G), BGS ‘Wow Policy Prev Polley No Pres Paley Your PolicyNo: 9S4301/3TIBFeI0000N47S—aeuason —S0NZ0I8 J Package (Goods Catrfngl Other than 2h Pte Crs) Ccligction No: 35430181 7160000002060 CCltecton Oat : 040772016, INSURED OETAILS, Name JALAN TRANELOGISTIOS INDIALTO 7 Address: BUISNESS CENTRE VILLAGE AHIJURI NS, TEHSIL OWARUMERA, REWAR Dat SREWARL Haryana PIN Cove: 123106, Telephone ProtessonBusiness: Net Mentioned PERIODOF NSURANGE From? SAOuRo16 ——TeTHbT Yo: _vdnightof 20067017 [iaent Code: s104050000000% Tagent Contact No; 9011364839 [ Business Source Code: #10406 ‘Avent Namver_Alvance Life nurance Brokers Pv Lid Mais Offee Vehicle make [ ASHOK LEYLAND 16164 pata = TE T= mae ae, oT se [Se | oe, wth | neaeton = aes ED pee ee fren [ici 1 rs JINSURED DECLARED VALUE Power of Battery ‘Extension: ‘No Extension _— TOV of Vehicle Won Etectrieal ‘Electrical “T ENGI Kit 10 of Trailer Te sees | mage z aS Ls 3 8 sas ro aa] Sa oT ane ma KOS BASE Soca OV ‘ut Depreciation Presi =e rE 1 ae Bead sar Worms pansancgo TAT INCASE OF DISHONOUR OFTHE PREMUM went GUSH e080 ae eee Ie STAiGS AUTMATICALY CANCELLED ASNT. yao hua: € aa - “eal roma 2 ssir00 compsteery Exse € 1.000 Imposed Excass:t 0 Voluntary Excess: ee i ng me ETT Fao a est 188 Te Poy dowel cver xe rs) Oneniced Racing) Pace Mating) RelabiyTrlas) SpeesTesing e Nee ee eee aoa netnttanee asain manos then cantetneal cet ea einem nti man ttre om a nth lr oa oc guos itu tne face and tthe prt sstose requremets of ile $f Mor Veuos ules, ‘es, Timi of Lsbiy Under Seton In vupect of anos accident As par Motor Vehiies at ‘ecm sree clam ang gto one eer: € 720000 Under Seton iin reaper of any Cars So Tra ws reer Cm Sous GBin ove Garage Gia pO fo Gam mate png ua Fa siete hep ut, rece terest ond en ns a mn _rerowec within 9C days of the axpey dale of te previous policy. te me re - [Financier ‘DCB BANK LTO, BranchNet Given e. [izeecsion ‘GN We: Ur0200%8 40860100175. ROA Reg, No 58