unirep imoi

UNITED INDIA INSURANCE COMPANY LIMITED

213-215, NAMDHARI CHAMBERS D.B.GUPTA ROAD, KAROL BAGH NEW DELHI, NEW DELHI,
DELHI
CENTRAL DELHI: 110005 DELHI
PH: (011) 23531974 FAX: EMAIL:

MOTORCYCLESCOOTER
PACKAGE POLICY
UIN: IRDAN545RP0222V01200708
POLICY NO.:0404013121P109371435
VEHICLE NO.:TS - 09 - FD 3174

PERIOD OF INSURANCE
From 17:55 Hrs of 14/12/2021
To Midnight of 13/12/2022

Insured
M/s G4S SECURE SOLUTIONS INDIA PVT. LTD.
DELHI. 110058
C-16, COMMUNITY CENTER, JANAKPURI, BEHIND JANAK CINEMA, NEW
110058
WEST DELHI
DELHI

Agent Name : OPTIMA INSURANCE BROKERS

Agent Code BRCO000222

Mobile/Landline Number/Email
9810607324
amit.mathur@optima.co.in

The genuineness of the policy can be verified through "Verify Your Policy" link at www.uiic.co.in.

For any Information, Service Requests, Claim intimation and Grievances please write to 040401@uiic.co.in

Download Customer App(www.ulic.co.in ). REGD. & HEAD OFFICE, 24, WHITES ROAD, CHENNAI 600014,

Website: http://www.uiic.co.in
Printed By: JIT46391 15/12/2021 3:08:36 PM

This document is digitally signed

Signer: N MOHAN SANKAR

Date: wed, Dec 15, 2021 15: ST
Location: United India Insuesce Ampany Ltd
1/4 Reason: Signing Policy forli
 niTED InDIR

UNITED INDIA INSURANCE COMPANY LIMITED

CERTIFICATE OF INSURANCE
MOTORCYCLE/ ScooTER PACKAGE POLICY
OIN: IRDAN545RP0222v01200708
(FORM 51 OF CENTRAL MOTOR VEHICLE RULES 1989)
Policy No.
Customer Id_
0404013121P109371435 Certificate Number 0404013121P109371435
Neme of the Insured 23042625668
s SECURE SOLUTIONSINDIA PVT.213-215, NAMDHARI
Address
CHAMBERS
Code 040401
LTD D.B.GUPTA ROAD, KAROL BAGH NEW DELHI, NEW DELHI, DELHI
C-16, COMMUNITY CENTER, JANAKPURI,
BEHIND JANAK CINEMA, NEW DELHI. 110058 110005
CENTRAL DELHI
Address of the Insured,
10058 DELHI
WEST DELHI Telephone_ K011) 23531974
|DELHI
Business/Occupation None Telephone_
Tnsured's Declared Value 22162
Period of Insurance_
Particulars of Vehicle Insured From 17:5 Hrs of 14/12/2021 To Midnight of 13/12/2022
Registration No. Obsolete
Vehicle Engine No. Chassis No. Make/ Model Year of Mf Type of Cubic Seating
Body includin9
TS 09 FD 3174 No
Capacity/KW driver
1285805 K91430 TVS/ JUPITER 110CC 2016 Solo with 110
Registration Authority Geographical Area Pillion
TS09 KHAIRTABAD,
HYDERABAD DISTRICT INDIA
Amount in words:
Persons or classes of personsOne thOusand
entitled one hundred sixty-four rupees only
to drive
Any person including Insured provided that a person holds an
holding or obtaining such a licence. Provided also that the effective driving licence at the time of
accident and is not disqualified from
such a person satisfies the requirements person holding an effective Learner's
Licence may also
Limitations as to use of Rule 3 of Central Motor Vehicle Rule, 1989. drive the vehicle and
Premi
The policy covers use of the vehicle for any CGST(9%):_ 986.00
a) Hire or Reward purpose other than
b) Carriage Goods (other SGST(9%):_ 89.00
than
c) Organized Racing samples or
personal luggage) Stamp Duty: 89.00
d) Pace Making Total(Rounded off):_ 1.00
e) Speed Testing and Reliability Trials Receipt Number: 1,164.00
Use in connection with Motor Trade
Receipt Date: 10104040121110526208
DebitNote Number: 15/12/2021
Limits of Liability Document Date:
Under Section II-I Death or Agen Broker Code:
accident; As per Motor ehicles bodily injury
Act 19888 in respect of any one
OPTIMA INSURANCE BROKERS
UnderoneSection 11-I (ii) Direct Business: BRCO000222
Damage to third
party
claims arising out property
any in
claim or series of respect
of one event:
of
100000 /-- Dev Officer :
Subject to IMT Endorsement
1/We hereby certify that the No.s, terms and conditions printed herein / attached
the certificate of policy to which the certificate relates as hereto 22
insurance are issued in accordance well as
Chapter x & XI of M.V Act, 1988. with provisions of
For and On behalf of
Date of Issue: United India Insurance Co. Ltd.
15/12/2021

Duly Constituted Attorney

21A
 O 3
a << 3
N
 Policy/vo,: 04M013121P10937143
SCHEDULE OF PREMIUM (IN )_ LIABILITY
oWN DAMAGE

on Vehicle and Accessories B. Basic TP 752.00

Basic premium
A. Basic OD 234.12 Total 752.00

Total 234.1

Gross TP(B) 752.00

TP:
Gross OD(A) 234.00 Gross OD & 986.00
(A) + (B)

AMOUNT IN WORDS: One thousand one hundred sixty-four rupees only

TERMS AND CONDITIONS

AS PER THE INDIAN MOTOR TARIFF. PERSoNAL COPY OF THE SAME 1s AVAILABLE FREE OF COST.O REQUEST.FURTHER THE INDIAN
MOTOR TARIFF IS ALSO AVAILABLE AND DISPLAYED AT ALL UNITED INDIA INSURANCE COMPANY OFFICES AND ON UIIC WEBSITE
www.uiic.co.in
DISCLAIMER: THE POLICY STANDS CANCELED ORVOID IN THE EVENT OF CHEQUE DISHONOR THE CoMPANYMAY CANCELTHE POLIC RY
SENDING 7 DAYS NOTICE IN CASE OF ANY FRAUD OR MISREPRESENTATION, NON-DISCLOSURE OF MATERIAL FACT OR NON-CO-0PERATION
OF THE INSURED.

IMPORTANT NOTICE
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 WI1DER TERMS APPEARING IN THE CERTIFICATE IN ORDERTO COMPLYWITH THE MOTOR
VEHICLES ACT, 1988 IS RECOVERABLEFROM THEINSURED.SEE THE CLAUSE HEADED "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF
RECOVERY". FOR LEGAL INTERPRETATION, ENGLISH VERSION WILL HOLD GOOD.

Agency/Broker Code: BRCOGO0Z22

Premium: 986.00Receipt Number: 1010404012111052620s0PTIMA INSURANCE
BROKERS_
CGST(9%): 89.00Receipt Date 15/12/2021Direct Business:
SGST(9%): 89.0
00
Development Officer
Stamp Duty: .00DebitNote Number
Code:
Total (Rounded Off): R1,164.00Document Date

Customer GST/UIN No.: 07 AAACG1625Q1ZG office GST No.: 07AAACUsss2C1ZL

997134 |Invoice No. & Date 31211109371435 & 15/12/2021
SAC Code:
AmountSubject to ReverseCharges-NIL
Anti Money Laundering Clause:-In the event of a claim under the policy exceeding1 lakh or a claim for refund of premium exceeding
1 lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company's web site.

LET US 10IN THE FIGHT AGAINST CORRUPTION. PLEASE TAKE THE PLEDGE AT https://pledge.cv.nic.in.

Date of Proposal and Declaration: 15/12/2021

IN WITNESS WHEREOF, this policy has been signed at BO JHANDEWALAN 040401 on this 15th day of December 2021.

For and On behalf of

United India Insurance Co. Ltd.

Affix Policy
Stamp here.

Duly Constituted Attorney:

Underwritten By - JIT46391 ( B0 UNDERWRITER)

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