MOTOR SECURE - COMMERCIAL MOTOR INSURANCE – COMPREHENSIVE POLICY

CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE - Form 51 of the Central Motors Vehicles Rules, 1989 Policy
Servicing: Off Code-56, Future Generali India Insurance Co Ltd, GMT House, 3rd Floor Plot No.2 Setiwada, Dahisar,
Office Dahisar, Mumbai Maharashtra, 400 068, Tel_No: 022-2418485701
Policy No. : 2021-V9876188-FTX Period of Insurance : From 00:00 hrs of 03/09/2021 To
Insured : MR ABDUL SALAM AL SHAIKH Midnight of 02/09/2022
Address : BIT CHAWL NO 1 ROOM NO 52 Covernote No : Dated: Zone: C
1ST FLOOR I R ROAD Intermediary Name/Code : Direct
MUMBAI Telephone : 1800-220-233,1860-500-3333
MAHARASHTRA - 400 003
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Registration No., Make/Model of Vehicle Engine No. Chassis No.
RTA Location
MH 01 BD 1498 MARUTI 160900 278195
ECCO 4+1 STR
Year of Manufacture Cubic Capacity Seating Capacity Gross Vehicle Weight
2012 1196 5 1540
DRIVERS CLAUSE - Any person including insured:Provided that a person driving holds an effective driving license at the
time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding
an effective learners license may also drive the vehicle when not used for the transport of goods *at the time of the
accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules 1989.
* When the vehicle is used for passengers add the following words: when not used for the transport of passengers at
time of the accident.
LIMITATIONS AS TO USE - The Policy covers use 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 for a) Organized racing b) Pace Making c) Reliability Trails d)Speed Testing
Geographical Area : INDIA ,
IMPORTANT NOTICE
The Insured is not indemnified if the vehicle is used or driven otherwise in accordance with this schedule. Any payment
made by the Company by 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”. For legal interpretation English version will be good.
For full details on coverage, terms, conditions and exclusions, please refer the standard policy wordings attached with
this schedule.
Not with standing anything mentioned herein to the contrary it is agreed and declared that the cover under this policy
does not extend to those parts mentioned as damaged /scratched/ dented noted in the photographs/inspection report
number 21-REX-300317-596849 dated 31/03/2017
IMPORTANT - 1) All other Terms, Conditions and Exclusions as per attached Policy Wordings. 2) In case of payment by
cheque, in the event of dishonor of cheque for any reason what so ever, insurance cover provided under this document
automatically stands canceled from the inception irrespective of whether a separate communication is sent or not.
**NCB has been allowed 35 % on the basis of your declaration of 'No Claims' in your expiring policy. In case, we find that this
declaration is incorrect and/or false, all benefits under the Policy in respect of Section I of the policy will stand forfeited.
LIMITS OF LIABILITY
Under Section II-I (i) :Death of or bodily injury -Such Under Section II-I (ii) : Damage to Third Part Property - ₹
amount as is necessary to meet the requirements of Motor 750000/- in respect of any one claim or series of claims arising out
Vehicles Act, 1988. of one event.
Under Section III : PA Owner – Driver as per premium Compulsory Deductible Under Sec I : ₹ 500.00
computation table.
Hypothecation Agreement with: THE CHEMBUR
NAGARIK SAHAKARI BANK LTD
SPECIAL CONDITIONS – NIL
ADDITIONAL EXCESS – NIL
The nominee for Compulsory PA to owner driver cover is 01) Legal Heir, aged :36 Years, Relationship : Legal Executor,
Nomination % : 100%
Policy No: 2021-V9876188-FTX Period Of Insurance : From 00:00 hrs of 03/09/2021 To Midnight of 02/09/2022
INSURED'S DECLARED VALUE
Type of Body For Vehicle For Vehicle For Non-Elec For Trailers-₹ For Elec / Electronic For Bi-Fuel Kit TotalValue-
-₹ Body- ₹ Accessories- ₹ Accessories - ₹ (CNG/LPG)- ₹ ₹
0 0 - - - - 0
TAXI

SCHEDULE OF PREMIUM
PARTICULARS ₹ ₹
A-OWN DAMAGE
Basic Premium on Vehicle 00.00
Add : IMT 23-Cover for mud-guards etc 00.00
**Less : No Claim Discount 00.00
Total Own Damage Premium (A) (rounded off) 00.00
B-LIABILITY
Basic Premium including Premium for TPPD 11,320.00
Add : Compulsory PA to Owner-Driver Rs. 2 lacs 50.00
Add : Legal Liability to Driver/Cleaner/Conductor (No. of persons 1) 00.00
Total Liability Premium (B) 11,370.00
Total Annual Premium (A+B) 11,370.00
Total Premium for the Policy Period 11,370.00
Gst @ 18% Including Cess 2,046.00
Total Premium (rounded off) 13,417.00
Class of Vehicle : Goods Carrying-Public Carriers (Other Subject to Endorsement Nos. 21 ,23 ,28 ,15
Than 3 Wheelers)
I/We hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in
accordance with the provisions of chapter X and chapter XI of M .V. Act, 1988.

For FUTURE GENERALI INDIA INSURANCE CO. LTD.

Receipt No : Z7037960
Date of Issue : 03/09/2021
Place of Issuance : Mumbai*
(Authorized Signatory)
*Address as mentioned below.

Note:This document is digitally signed by Sharada Ramakrishnan, Authorised Signatory of

Future Generali India Insurance Company Limited on 31/12/2004.

For registration of your Motor claims SMS MOTORCLAIM to 9222211100 ( Standard SMS charges applicable )

The stamp duty of Rs. 0.50/- paid by GRAS DEFACE NO. 0004183279201617, dated 03/09/2021. Mudrank
2004/4125/CR/690/M-1,dated 31/12/2004.