HDFC ERGO General Insurance Company Limited

2354100800712500000
Certificate of Insurance cum Policy Schedule
Policy No. 2354 1008 0071 2500 000

Trailer liability Policy through CSC

0

SRIKAKULAM
Insured Name MR KRISHNARAO B RTO PAN No.
PALASA
Corr.Address/ D No 101 Chinnaraopalli Vill Etcherla
Place of Supply SRIKAKULAM ANDHRA PRADESH,532410
Mobile 9502605282 Phone - E Mail chendra.allu@gmail.com Registration No. AP-30-T-9570

Period of Insurance From Date & Time 13/06/2020 00:01 hrs. To Date & Time 12/06/2021 Midnight Policy Issuance Date 12/06/2020

Number of
Make Model - Variant Mfg Yr Trailer Type Chassis No
Trailer towed
SRI VENKATA SAI Other Vehicles Including Class 2212003
TRAILER 2003 1
ENG WORKS D vehicles

Trailer (`) Total IDV (`)

Insured's Declared Value(IDV)
0.00 0.00

Premium Details (`)

Liability Premium(b)
Basic Third Party Liability: 2341

Sub Total - Addition 2341

Net Liability Premium (b) 2341

GST 12% on Basic Third Party Liability Premium 281

Total Tax 281

Total Premium 2622

Geographical Area India

Payment Details: Fund Transfer No. LP2006831518 Dated: 12/06/2020 drawn on: BizDirect Invoice No.: 100800712500000 HSN Code: 997134

LIMITATIONS AS TO USE: The Policy covers use of the vehicle only under a permit within the meaning of the Motor Vehicle Act 1988 or such a carriage falling under Sub-Section (3) of Section 66 of the
Motor Vehicle’s Act 1988. The Policy does not cover use of the vehicle for a) Organized racing b) Speed Testing. Limits of Liability 1. Under Section II-1 (i) of the policy - Death of or bodily injury - Such
amount a s i s necessary to meet the requirements of the Motor Vehicles Act, 1988. 2. Under Section I I - 1(ii) of the policy -Damage toThird Party Property - ` 750000 Terms, Conditions and
Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request & the same is also available at our website.
Insured is carrying on or engaged in the business or occupation of and no other for the purposes of this Insurance
I / We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of M. V.Act 1988."The stamp duty of
0.50 paid b y Demand Draft, vide Receipt/Challan no. CSD/36/2019/2289/19 dated 27-05-2019 a s prescribed in Government of Maharashtra Order No. Mudrank – 2004/4125/CR690/M-1, dated the
31/12/2004". Goods and Service Tax Registration No: 33AABCL5045N1ZF. IMPORTANT NOTICE: The Insured i s not indemnified if the vehicle is used or driven otherwise than in accordance with this
Schedule. Any payment made b y the Company b y reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause
headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY". Disclaimer: The Policy shall be void from inception if the premium in full is not realised by the company. In the event of
misrepresentation, fraud or non-disclosure of material fact, the Company reserves the right to cancel the Policy from inception. In the event of an accident, the insured should inform company immediately to
arrange Spot Survey.I understand that the risk shall commence from the start date 13/06/2020 as specified in the Period of Insurance section of the Trailer liability Policy through CSC. Goods and Service
Tax for this invoice is not payable under reverse charge basis.
Branch :LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, MUMBAI, 400059. Phone No. : +91-22-66383600
Policy Issuing Office: Mumbai For HDFC ERGO General Insurance Company Ltd.

CSC Name : CSC E GOVERNANCE SERVICES INDIA

LIMITED
CSC Code : 201764376894
UIN: HDE-MT-P16-30-V01-16-17
VLE ID : 147826300018 Duly Constituted Attorney

VLE Name : Allu Chandrasekhar Contact No : 7382244992

HDFC ERGO General Insurance Company Limited. (Formerly HDFC General Insurance Limited from Sept 14, 2016 and L&T General Insurance Company Limited upto Sept 13, 2016). CIN:
U66030MH2007PLC177117.Registered & Corporate Office: 1st Floor,HDFC House, 165 - 166 Backbay Reclamation,H. T. Parekh Marg, Churchgate, Mumbai – 400 020.Customer Service Address: D-301, 3rd
Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078. Customer Service no : 022 - 6234 6234 / 0120 - 6234 6234 Te.: +91 22 6638 3600 | Fax: 91 22 6638 3699 |
care@hdfcergo.com | www.hdfcergo.com. UIN : HDE-MO-P16-19-V01-16-17 IRDAI Reg No.146