HDFC ERGO General Insurance Company Limited 2990100801371400000

Policy Schedule
Policy No. 2990100801371400000
Home Shield Insurance

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GSTIN:
Insured Name Mr RAKESH DANDU Gender MALE PAN No.
Correspondence 754 Chandanwadi CGHS Sec 10 Plot 8 Dwarka SOUTH WEST Risk Location
H 901 Sec 86 Microteck Greenburg GURGAON, 122004
Address DELHI, 110075 Address
HARYANA
DELHI
Mobile 9971258717 Phone E Mail RAKESH.DANDU@GMAIL.COM
Period of Insurance From Date & Time 14/06/2020 00:01 hrs To Date & Time 13/06/2021 Midnight Age of Building Less than 25 Years
Hypothecation :
Loan Account No.
Coverage Details & Sum Insured (`)
Description of Property Covered Basis of Sum Insured Built up Area X (Cost of Construction/ Ready Sum Insured
Recknor/ Agreement rate)
Contents Reinstatement Value 10656000 500000
Building excluding Plinth & Foundation Agreed Value 1480sq.ft*7200 10656000
List of Add-on Covers (`)
Description of Property Covered Sum Insured / Limit of benefits
Brokerage for Alternate accommodation 50,000.00
Emergency Purchases 20,000.00
Rent for alternative accommodation (Rs 50000Per month for 24 months) 1,200,000.00
Hotel Stay (Rs.5328*15 days) 79,920.00
Expenses of shifting to alternate accommodation 50,000.00
Keys and locks replacement cover 20,000.00
Premium Details (`)
Basic Premium 4506.00
Terrorism Premium 0.00
Integrated Tax 18% 811.00
Total Premium 5317.00
Payment Details
Cheque No./DD/Fund Transfer Date Bank Name
Fund Transfer No. 1722006065962 13/06/2020 BizDirect
SPECIAL CONDITIONS/CLAUSES/WARRANTIES
Basis of Valuation for Building is REINSTATEMENT VALUE
Basis of Valuation for Content is REPLACEMENT VALUE. Contents are covered on Loss limit basis
Rent for alternative accommodation Clause(24 months)
Hotel Stay Clause (15 days)
Expenses of shifting to alternate accommodation clause
Brokerage for Alternate accommodation
Emergency Purchases Clause
Keys and locks replacement cover clause
Warranted 24 hours security guards at all entry/exit & All flats/apartments inter-connected by intercom to entry /exit gate and with each other
Terrorism Cover Exclusion Endorsement
Warranted there is no Kutcha Construction at insured premises Kutcha Construction : Building(s) having walls and/or roofs of wooden planks/thatched leaves and/or grass/hay of
any kind/bamboo/plastic cloth/asphalt
Excess Applicable
Policy Excess : Rs. 5000/- Each and every claim
Details of Portable Electronic Equipments
Brief Description of item with make /model Value Year of Mfg. Sr. No / Unique Identification No
Details of Work of Art/Jewellery
Sr. No Brief Description of item Value Year of purchase/acquisition Dimension Weight **

**Applicable for Jewellery only

For Queries/Claim Services Customer Service No. 022-6234 6234/0120-6234 6234 E-mail care@hdfcergo.com
Address 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059.
If the premium is not realised the policy shall be void from inception. Where proposal forms are not received, information obtained from an insured whether orally or otherwise is captured in the cover note, if
issued, and / or in the policy document. Discrepancies, if any, in the information contained in the policy document may be pointed out by an insured within 30 days from policy issue date after which
information contained in the policy shall be deemed to have been accepted as correct.
" Consolidated stamp duty for this Insurance Policy is paid by Demand Draft,vide Receipt/Challan no. 3971896201415 dated 10/03/2015 as prescribed in Government of Maharashtra Order No. Mudrank –
2017/CR.97/M-1, dated the 09th January 2018"..Goods and Service Tax for this invoice is not payable under reverse charge basis.

Policy Issuing Office : LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, MUMBAI, 400059. Phone No. : +91-22-66383600

Agent Name :ONLINE SALES For HDFC ERGO General Insurance Company Ltd.

Agent Code :200278133519

Duly Constituted Attorney

The Policy wording attached herewith includes all the standard coverage offered b y the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits a s mentioned
in this policy schedule. For any clarification please call our toll free number.

HDFC ERGO General Insurance Company Limited UIN : IRDAN125P0001V01201718 || IRDAI Reg No.146 || CIN: U66030MH2007PLC177117
Registered & Corporate Office: 1st Floor, HDFC House, 165/166 Backbay Reclamation, Customer Service Address: D 301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg,
H.T.Parekh Marg, Mumbai - 400 020 Bhandup (West), Mumbai - 400 078
HDFC ERGO General Insurance Company Limited 2990100801371400000

Proposal No. 2990100801371400000

Home Insurance - Proposal Form For Home Shield Insurance Policy

Insured Name Mr RAKESH DANDU Gender MALE PAN No. [
Correspondence 754 Chandanwadi CGHS Sec 10 Plot 8 Dwarka SOUTH WEST Risk Location
Address DELHI, 110075 Address
H 901 Sec 86 Microteck Greenburg GURGAON, 122004 N
HARYANA
DELHI
Mobile 9971258717 Phone E Mail RAKESH.DANDU@GMAIL.COM
2020-06-14 00:00:00.0 2021-06-13 00:00:00.0
Period of Insurance From Date & Time To Date & Time Age of Building Less than 25 Years
00:01 hrs Midnight
Type of Ownership A Home Owner Security Measure Both Escalation No
Property under loan No Salaried Employee ? Yes
Coverage Details & Sum Insured (`)
Description of Property Covered Basis of Sum Insured Built up Area X (Cost of Construction/ Ready Sum Insured
Recknor/ Agreement rate)
Contents Reinstatement Value 10656000 500000
Building excluding Plinth & Foundation Agreed Value 1480sq.ft*7200 10656000
List of Add-on Covers (`)
Description of Property Covered Sum Insured / Limit of benefits
Brokerage for Alternate accommodation 50,000.00
Emergency Purchases 20,000.00
Rent for alternative accommodation (Rs 50000Per month for 24 months) 1,200,000.00
Hotel Stay (Rs.5328*15 days) 79,920.00
Expenses of shifting to alternate accommodation 50,000.00
Keys and locks replacement cover 20,000.00
Premium Details (`)
Basic Premium 4506.00
Terrorism Premium 0.00
Integrated Tax 18% 811.00
Total Premium 5317.00
Payment Details
Cheque No./DD/Fund Transfer Date Bank Name
Fund Transfer No. 1722006065962 13/06/2020 BizDirect
SPECIAL CONDITIONS/CLAUSES/WARRANTIES
Basis of Valuation for Building is REINSTATEMENT VALUE
Basis of Valuation for Content is REPLACEMENT VALUE. Contents are covered on Loss limit basis
Rent for alternative accommodation Clause(24 months)
Hotel Stay Clause (15 days)
Expenses of shifting to alternate accommodation clause
Brokerage for Alternate accommodation
Emergency Purchases Clause
Keys and locks replacement cover clause
Warranted 24 hours security guards at all entry/exit & All flats/apartments inter-connected by intercom to entry /exit gate and with each other
Terrorism Cover Exclusion Endorsement
Warranted there is no Kutcha Construction at insured premises Kutcha Construction : Building(s) having walls and/or roofs of wooden planks/thatched leaves and/or grass/hay of any
kind/bamboo/plastic cloth/asphalt
Excess Applicable
Policy Excess : Rs. 5000/- Each and every claim
Details of Portable Electronic Equipments
Brief Description of item with make /model Value Year of Mfg. Sr. No / Unique Identification No

Details of Work of Art/Jewellery

Sr. No Brief Description of item Value Year of purchase/acquisition Dimension Weight **

**Applicable for Jewellery only

Anti Rebate Clause
1. No person shall allow or offer to allow, either directly or Indirectly as an Inducement to any person to take out or renew or continue an insurance In respect of any kind of risk relating to lives or property in
India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept rebate except
such rebate as may be allowed In accordance with the published prospectus or tables of the insurer.

2. Any person making default in complying with the provisions of this Section shall be punishable with fine which may extend to `10 lakhs.

Anti Rebate Clause

I/ We hereby declare and warrant that I am / We are the legal owner/ owners / tenant of the property proposed to be insured, being the subject matter of the insurance.
In the event the Building is proposed to be insured under the Policy, I/ We declare and warrant that I am / We are the legal owner/owners of the Building proposed to be insured and that I / We have all obtained
and I am / We are in the possession of all the necessary approvals and permissions provided by the requisite authorities with respect to the Building. I / We hereby declare that the Building proposed to be
insured i s legally constructed after obtaining all the necessary permissions and approvals and that construction of the Building has been completed in all respects and is currently being occupied by me / us or in
the event the Building is occupied by my/our tenant, the same is in my/our legal dominion or actual or juridical possession.
I/We agree that this declaration and the answers given above shall be the basis of the contract between me/us and the Company and shall be deemed to be incorporated in such contract. And that if any untrue
statement be contained therein the said contract shall be absolutely null and void. I/We undertake to exercise all reasonable and ordinary precaution for the safety of the building/ contents and I/We agree to
accept the policy in the form issued by the Company subject to the terms exceptions and conditions prescribed therein or endorsed on the policy.

Disclaimer : Proposal Form and Policy Schedule have been generated basis details entered by proposer / insured on Online Platform (either on HDFCERGO.com or its affiliated Online Channels (IRDAILicensed
Intermediaries). For any modification, kindly visit URL: https://www.hdfcergo.com/customer-care/customer-support.html and register your service request or write to us at care@hdfcergo.com

Customer Name : RAKESH DANDU PAN:

HDFC ERGO General Insurance Company Limited UIN : IRDAN125P0001V01201718 || IRDAI Reg No.146 || CIN: U66030MH2007PLC177117
Registered & Corporate Office: 1st Floor, HDFC House, 165/166 Backbay Reclamation, Customer Service Address: D 301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg,
H.T.Parekh Marg, Mumbai - 400 020 Bhandup (West), Mumbai - 400 078