Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Private Car Liability Only Policy
UIN No.: IRDAN158RP0002V01201718

Name HAREKRISHNA PARIDA Vehicle Registration No. UA07M2277

N PROBUS INSURANCE
Partner Name
00 87,Mitealok Colony Ballupur Road 3dehradun BROKER LIMITED
Address
Uk,Dehradun-248001 1001221
Partner Code
1000013
Mobile xxxxxxxxx8337 Partner Mobile No. +917304332968
Email kxxxxxx5@gxxxl.com Partner Email bcc@probusinsurance.com
Aadhar No. -- For Claims,contact us at 1800-258-5956

YOUR POLICY DETAILS

Policy No. D034247049 / 05052021 Policy Issue Date 05-May-2021 Invoice No. IA036351201
From 06-May-2021 21:02:59 Invoice Date 05-May-2021
Period of Policy
To 05-May-2022 23:59:59

YOUR VEHICLE DETAILS

M
Seating
RTO Location Dehradun,UTTARAKHAND 5
Capacity

Make HONDA Model/Vehicle Variant (Sub-Type) CITY/1.5 Gxi

Engine No. L15A30058978 Chassis No. MAKGD852H5N232026 Cubic Capacity 1493 CC

Fuel Type Petrol Year of Mfg. 2006 Year of Regn. 2006

FASTag Number NA
E
FASTag NUMBER DECLARATION
1
N The Policy has been issued subject to your affirmative declaration that a valid FASTag has been affixed on the insured vehicle.
IG
ENDORSEMENT
580
Invoice Number Invoice Date Gross Premium Igst Cgst Sgst Utgst Cess Net Premium

IA036351201 2021-05-05 3801.00 580.00 0.00 0.00 0.00 0.00 3221.00

LIABILITY PREMIUM (`)

Basic Third-Party Liability (`) 3221 PA cover for Owner-Driver (`) --
PA cover for 5 passengers 0 (`) -- TP for Bi-fuel kit (`)
Legal Liability for Operation / Maintenance (`) -- Legal Liability to Paid Driver (`) --
PA Cover for Paid Driver (`)
Net Premium (`) 3221
IGST @ 18% = (`580) 3221
F 580

Final Premium (`) 3801

OTHER DETAILS
Previous Insurer
Previous Policy No. -- Previous Policy Expiry Date
IMT - Endorsements --
GSTIN/UIN No. Unregistered State Code 5
Payment Mode Online 19_dp-DIC68028165D90-1
G0
Bank Name IFSC/MICR No --
Receipt No. RA038249563 Receipt Date 05-May-2021
Nominee Details --
Financier Details --

Other details --

J
POSP INFORMATION AKA PARTNER DETAILS

Name Karan Thapa

Unique Number BSDPT2507B
Location Dehradun

PAN Number BSDPT2507B

Aadhaar Number xxxxxxxx2205

Mobile Number xxxxxx8337

Geographical Area: Any liability incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and endorsed.. Limitation as to use: The
policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial, speed testing and use for any purpose in connection with the Motor
Trade. Person or Class of persons entitled to drive: Any person including the insured. 1) Provided that a person driving holds a valid effective driving license at the time of the
accident and is not disqualified from holding or obtaining such a license. 2) Provided also that the person holding a valid & effective Learner’s License may also drive the vehicle
and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and any subsequent amendment as applicable. Limits of Liability: 1) Under
Section II - 1 (i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988. 3) Under Section II - 1 (ii) of the policy:
Damage to Third Party Property - ` 750000 4) P.A. Cover for Owner Driver under Section III (CSI) - ` 0

PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of your declaration that you do not hold a valid
Driving License on or before the date of commencement of this Policy / already have an alternate Personal Accident insurance cover of Rs. 15 Lakhs

PUC Declaration:The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of commencement of the
Policy .

Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.
Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in case of dishonor of Cheque or non-receipt of payment. Violation of Motor
Vehicle Act: This policy is issued in accordance with the provision of Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will
forfeit all benefits and coverages under the Policy. The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made
by the Company by reason of wider terms appearing in 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) in the policy. This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in
addition to Indian Motor Tariff. Policy would be void on the ground that it was obtained by non- disclosure of material fact or by a representation of fact which was false in some
material particular.

Note: The terms and conditions detailed in this policy schedule as well as the policy document sent by Digit shall prevail in case of any dispute.

For & On Behalf of Go Digit General Insurance Ltd.

In case of claim or any other query, please

contact our 24-hour Call Centre at 1800-258-
5956 or email us at hello@godigit.com or visit
our website www.godigit.com Praveen Bhat
Vice President-Customer Experience
praveen.bhat@godigit.com
Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty has been paid as per Letter of
Authorization No.67-B/04/2017-18 Date: 30th May 2017
issued by Department of Stamps and Registration ,
Bengaluru- 560009 - KARNATAKA.
Hey, our document is now digitally signed
Click here to view the certificate.

Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. IRDAI Reg No. 158 CIN
U66010PN2016PLC167410, GST Reg. No.:27AACCO4128Q1Z0 HSN: 9971/General Insurance Services, GSTIN Address:Mumbai Business Centre,13th Flr, Godrej Coliseum,
Lokmanya Pan Bazaar,Behind Everard Nagar,Sion(E),Mumbai,Maharashtra,PIN-400022