Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Commercial Vehicle Package Policy UIN No.: IRDAN158P0001V01201819

Name MD INTAKHAV ALAM Vehicle Registration No. BR07GA4659

Partner Name CHANDA KUMARI JHA
S/O MD TAMANNA AT BASAWARIYA
Address 1032541
PO NURCHAK PS BISFI, MADHUBAI-847211 Partner Code
1032541
Mobile xxxxxxxxx3882 Partner Email amitjha
Email axxxxxxxxxxxxx1@gxxxl.com Hypothecation MMFSL
KFZ PAN (POSP) HWXPK8067F
Goo Aadhar No. -- For claims,contact us at 1800-258-5956
YOUR POLICY DETAILS
N Policy No. D017456378/22062020 Policy Issue Date 22-Jun-2020 Invoice Date 22-Jun-2020
FH
1 From 22-Jun-2020 19:30:52
Period of Policy
To 21-Jun-2021 23:59:59
N
tru NCB % (Current Policy) 0% Policy Type Public Carrier
Compulsory Deductible 500 Voluntary Deductible --
YOUR VEHICLE DETAILS
HWX MAHINDRA AND
Make Trailer Reg. No. RTO Location Madhubani,BIHAR
MAHINDRA
Model/Vehicle Variant BOLERO/PICK UP CBC 2WD Year of Regn. / 2017 / -- Licensed Seating 2
(Sub-Type) Manufacturing Capacity
POSP GHH1B14604 MA1ZN2GHKH1B21270
Engine No. Chassis No. Cubic Capacity 2523 CC
Fuel Type Diesel Gross Vehicle Weight 2820KG Vehicle Body Type Pick Up Van

Goods Type -- Permit Type Public Carrier Wheels 4

YOUR VEHICLE IDV (THE MAXIMUM MONEY YOU CAN GET IN CASE OF A CLAIM)

G0 Vehicle IDV IDV of Electrical IDV of Non-Electrical CNG/LPG KIT IDV Trailer IDV Body IDV Total IDV
PI (`) Accessories (`) Accessories (`) (`) (`) (`) (`)

500000 -- -- -- -- -- 500000
KFZ
30 ADD-ONS (THE EXTRA COVERAGE FOR YOUR VEHICLE)
Add Name Other details
G01 OWN DAMAGE PREMIUM [A] (`) LIABILITY PREMIUM [B] (`)
C
93 Own Damage Premium (`) 3452 Basic Third-Party Liability (`) 15546
Add-Ons Premium (`) 0
PA cover for Owner-Driver (`) 330
NCB Discount Amount (`) -0
Total OD (`) Total Act (`) 15876
3452
Premium Premium

Net Premium [A+B] (`) 19328

1866
CGST @ 6% = (`933) + SGST/UTGST @ 6% = (`933)
682
CGST @ 9% = (`341) + SGST/UTGST @ 9% = (`341)
31
Total Premium (`) 21876

15 Note: The above total OD premium is inclusive of all applicable loading / discounts viz (automobile association memberships, voluntary excess, anti-theft
87 handicap person, driver tuition, fiber glass, CNG/ LPG unit, geographical extension, imported vehicle etc., wherever applicable).
6 Public
Carrie
If the “Own Damage Cover” under your policy is cancelled during the policy period, then your policy shall be governed by the standard terms and conditions
of “Act only” policy for the Third Party Cover during the remaining period of policy.
r

ENDORSEMENT
Invoice Number Invoice Date Gross Premium Igst Cgst Sgst Utgst Cess Net Premium

IA028266794 2020-06-22 21876.00 0.00 1274.00 1274.00 0.00 0.00 19328.00

PO
K

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.: 10AACCO4128Q1ZF HSN: 9971/General Insurance Services, GSTIN Address: Patna Business
Centre,No 509, Patna One Mall, Dak Bunglow Chowk,Patna,Bihar,PIN-800001