FAIRFIRST INSURANCE LIMITED

(Company No. PB 5180)

No. 33, St. Micheal's Road, Colombo 03, Sri Lanka.
Tel: 011-2428428 (Customer service)

CERTIFICATE OF INSURANCE

We here by certify that the policy to which this certificate relates is issued in
accordance with the Provisions of Part VI of the Motor Traffic Act, No.14 of 1951
as amended.

Certificate of Insurance No : DGMYC/PT0001717

1. Distinctive Number of Motor
Vehicle
2. Name of Policy holder
3. Address of Policy holder
4. Effective date of
Commencement of insurance for
the Purpose of the Act
5. Date of expiry of insurance
Branch
6. Excluded use:
7. Excluded Driver
8. Description of vehicles (other
than that specified in item1) the
use of which is authorized by the
policy and names Of persons who
may drive such Motor Vehicles
9. Excluded Liability
: WP-BEV-4737
: MR.RANDIMAL L A D S
: NO 272/B/1, SILVA MAWATHA,
HORAGOLLA, GANEMULLA , GANEMULLA -
WESTERN
: 26/03/2021
: 25/03/2022
: WEB
- Business purposes other than the business
purposes of the Policy holder.
(i) Any person other than the Policyholder or
any person other than a person driving with
the Policyholder’s Express or implied
permission.
(ii) Any person who is not the holder of a
driving license valid to drive such class of
vehicle unless she has held and Is not
disqualified for obtaining such license.
(iii) Any Person who drives after having
consumed liquor/alcohol/intoxicant.
: None
: The policy excludes liability for injury
caused or contributed to by conditions of
war.

This certificate is not transferable to any new owner of the vehicle, except as provided for
in Section 112A in the Motor Traffic Act No.14 of 1951 as amended.

If for any reasons the insurance is terminated or suspended during its currency, the
certificate must be returned to the Insurer or if the certificate has been lost or destroyed
an affidavit to that effect must be made. Failure to comply with this obligation is an
1
 FAIRFIRST INSURANCE LIMITED
(Company No. PB 5180)
No. 33, St. Micheal's Road, Colombo 03, Sri Lanka.
Tel: 011-2428428 (Customer service)

offence under the Motor Traffic Act No.14 of 1951.

IN CASE OF AN ACCIDENT:PLEASE CONTACT US ON(+94)011-2428428 Call Center OR

email:info@fairfirst.lk

Date issued: 26/03/2021 09:05 PM

Security Code : bc7d51c4e9abb64559d2a8cc42322c3d

FAIRFIRST INSURANCE LIMITED

(Company No. PB 5180)
No. 33, St. Micheal's Road, Colombo 03, Sri Lanka.
Tel: 011-2428428 (Customer service)

THIS IS A COMPUTER-GENERATED DOCUMENT. HENCE NO MANUAL SIGNATURE IS

REQUIRED.