THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Private Car Enhancement Cover Policy

Insured's Details Policy Details

Insured's Name: TARANJIT SINGH , Policy number: 36100531180300000680

Customer ID: PO66462781 (PAN No :NA) Period of cover: 02/07/2021 10:41:43 AM to 02/07/2022
11:59:59 PM

Insureds Address: DALJIT SINGH ,VILL- GURA, PO- Registration no. PB-08-DR-8818
BARA PIND,TEH-
PHILLAUR,DISTT-
JALANDHAR ,PUNJAB,

Prev. Policy no. NM Make/Model: HERO / HF DELUXE

Email: Receipt no. 36100581180000000877 - 02/07/21

Phone Number : / / 8427036914 Fax Number : NA / NA

GSTIN/UIN NA / NA

Issuing office New India Contact

Address GORAYA MICRO OFFICE (361005), Agent / Corp. Agent / Mrs. Deepika -
B-2/276,G.T. ROAD,NEAR BUS STAND,GORAYA,DIST. Broker / Banc (NIAAG00108907)
JALANDHAR , , , Assurance / Referral
PUNJAB , 144009. Code - Name /
POS/IMF/SPECIFIED
PERSON

Phone no / / 9592518170

Phone no 01826264400 Fax no. /

Fax no. NA / NA Email /

Email nia.361005@newindia.co.in Development officer Mr. DIRECT BUSINESS - (DI00001739)

level Name/Code

Claim Contact GORAYA MICRO OFFICE (361005) Claim Contact Detail B-2/276,G.T. ROAD,NEAR BUS
STAND,GORAYA,DIST. JALANDHAR,,;01826264400//

GSTIN 03AAACN4165C2Z2

SAC 998539 (Other non-life insurance services excl RI)

Policy Details

Geographical Area / Zone: India/B Year of manufacture: 2017

Name of the Financier: N/A Chassis no./Engine no.: MBLHAR206H4D16544/27547

Type of body: Saloon Variant: SCOTER/BIKE

Automobile Association none Colour: Black

membership:

Seating capacity including Driver: 2 Cubic capacity ( cc): 97

Cover Note No/Cover Note Issue / Name of registration authority: Jallandhar

Date:

IDV(In `)
 Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value

10000 0 0 0 0 10000

Cover Description Cover Opted Cover Description Cover Opted

Additional Towing Charges No Engine Protection Cover No

Return to Invoice Cover No Road Tax No

No Claim Bonus Protection Cover No Loss of Contents Cover No

High Value PA Cover No Personal Belongings Cover No

Consumable Items Cover No

Schedule of Premium

Own Damage Liability

Basic TP Cover

Compulsory PA cover for Owner Driver

(Sum Insured `15,00,000),PA cover for
UnNamed Persons

OD Premium in ` 750 TP Premium in ` 750

Net Premium in `: 830

GST in `: 50

Total Payable in `: 830

PA cover for named persons

Name CSI Opted(`) Nominee Relationship

none 0 NA NA

Premium and GST Details

Rate of Tax Amount in INR

Premium ` 750.00

SGST 9 623

CGST 9 623

IGST 0 0

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 XI of M.V. Act, 1988.NIA S.T.REGN No: AAACN4165CST178.

The policy is subject to PCEC endorsement attached.

Date of Issue: 02/07/2021

For and on behalf of The New India Assurance Company Limited

Duly Constituted Attorney(s)

Digitally signed stamp not need