Office Copy

UNITED INDIA INSURANCE COMPANY LIMITED

19, SUDHA COMPLEX NEELA SOUTH STREET, NAGAPATTINAM, NAGAPATTINAM, TAMIL NADU
NAGAPATTINAM - 611001 TAMIL NADU
PH: (04365) 241569 FAX: EMAIL:

MICRO-INSURANCE PRODUCT-CATTLE INSURANCE POLICY

POLICY NO:0911014721P106493860
( DUPLICATE )

PERIOD OF INSURANCE
From 00:00 Hrs of 22/09/2021
To Midnight of 21/09/2022

Insured
MS TAMILNADU LIVESTOCK DEVELOPMENT AGENCY CHENNAI (NATIONAL
LIVESTOCK MISSION)
ADAH, NEARBY NEW BUS STANTD NAGAPATTINAM
611001
NAGAPATTINAM
TAMIL NADU
IMPORTANT NOTICE: KINDLY UPDATE YOUR AADHAAR NO. AND PAN/FORM 60. PLEASE IGNORE IF ALREADY UPDATED.

Agent Name :
Agent Code :
Mobile/Landline Number/Email :

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 091101@uiic.co.in

Download Customer App(www.uiic.co.in). REGD. & HEAD OFFICE, 24, WHITES ROAD, CHENNAI - 600014.
Website: http://www.uiic.co.in
Printed By : AMA45428 @ 01/10/2021 3:28:09 PM

This document is digitally signed

Signer: N MOHAN SANKAR

Date: Fri, Oct 1, 2021 15:29:58 IST
Location: United India Insurance Company Ltd
1/5 Reason: Signing Policy for UIIC
Office Copy

MICRO-INSURANCE PRODUCT-CATTLE INSURANCE POLICY

WHEREAS the Insured named in the Schedule hereto has made to United India Insurance Company Limited(herein after called the
"Company", a proposal and declaration which shall be the basis of this contract and be deemed to be incorporated herein for the
Insurance hereinafter contained and has paid the premium stated herein.

THE COMPANY hereby agrees subject to the terms, provisions, conditions, contained herein or endorsed to otherwise expressed thereon
that if any animal described in the Schedule and belonging to the Insured shall die from any disease or accident (including fire and
lightning) contracted or occurring during the period of Insurance stated herein or any subsequent period in respect of which the insured
shall have paid and the Company shall have accepted the premium required for the renewal or extension thereof the Company will pay to
the Insured after receipt of proof of death satisfactory to the Company the loss which the Insured shall suffer by the death of such animal
not exceeding the Sum Insured in respect thereof as stated in the Schedule hereto or its Market value at the time of loss whichever is
less. However, the company's liability is restricted to 50% of Sum Insured or market value whichever is less if the animal prior to death
giving rise to a valid claim under the Policy is not pregnant or four months less of pregnancy or not in milk production.

Policy No. 0911014721P106493860

SCHEDULE
Policy No. 0911014721P106493860 Previous Policy No.
MS TAMILNADU LIVESTOCK DEVELOPMENT AGENCY
Name/ID CHENNAI (NATIONAL LIVESTOCK
MISSION)/ 23085793683
Insured Details
Tel (O): Tel (R) Fax:
Email Mobile:
Business / Occupation None Date of Declaration
Period of Insurance From 00:00 Hrs of 22/09/2021 To Midnight of 21/09/2022

Coinsurance UIIC 091101 : 100%

PREMIUM : Nineteen thousand two hundred ninety-five rupees only

Type of Cover: Named

DESCRIPTION OF ANIMALS INSURED

IDENTIFICATION Purpose Sum

Species/Breed Sex, Colour &
Sl. Name of the Animal's for Veterinarian Insured(
Indigenous/Cross Distinguishing AgeHeight
No. Owner/Borrower/Loanee Number(Ear which Name
breed/Exotic Marks )
Tag/Marks) Used
Female ,
SUBRAMANIYAN Dr M
1 100042520765 Bovine/CBJ/Crossbreed WHITE , 6 MILCH 25000
MURUGAIYAN MUTHUKUMARAN
WHITE
AAMZAVALLI Female , Dr M
2 100042520776 Bovine/CBJ/Crossbreed 4 MILCH 10000
SUBRAMANIYAN RED , RED MUTHUKUMARAN
Female ,
KALIYAMURTHY RED WITH Dr. M.
3 170252703054 Bovine/CBJ/Crossbreed 5 MILCH 25000
VENGETESAN WHITE , RED MUTHUKUMARAN
WITH WHITE
Female , Dr. M.
4 GANESAN PALANIVELU 170252702962 Bovine/CBJ/Crossbreed 7 MILCH 25000
RED , RED MUTHUKUMARAN
Female ,
SOMASUNTHARAM Dr. M.
5 100042529390 Bovine/HFX/Crossbreed BLOCK , 7 MILCH 25000
THIRUNAVUGARASU MUTHUKUMARAN
BLOCK
Female , Dr. M.
6 JAYARAMAN SHANMUGAM 170251660138 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female ,
RAMACHANDRAN Dr. M.
7 170252702973 Bovine/HFX/Crossbreed BLOCK , 4 MILCH 15000
GOVINTHARASU MUTHUKUMARAN
BLOCK
Female ,
SUNTHARMORTHY RED WITH Dr. M.
8 430079151268 Bovine/CBJ/Crossbreed 6 MILCH 25000
MARIMUTHU WHITE , RED MUTHUKUMARAN
WITH WHITE
Female ,
Dr. M.
9 CHELLAMAL MUNIYANDI 170252703021 Bovine/HFX/Crossbreed BLOCK , 4 MILCH 15000
MUTHUKUMARAN
BLOCK
Female ,
BLOCK WITH
Dr. M.
10 AYAPPAN SAVURIRAJAN 430079140886 Bovine/HFX/Crossbreed WHITE , 6 MILCH 25000
MUTHUKUMARAN
BLOCK WITH
WHITE
Female , Dr. M.

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 Female , Dr. M.
11 SANGEETHA RAMESH 170252703442 Bovine/CBJ/Crossbreed 6 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
12 RAMESH VIRAYAN 170252541258 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
13 KAVERI KALIYAPERUMAL 170257449628 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
14 SHANTHI RAJENDRAN 170251660138 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
15 VANATHI VARATHARAJAN 170252536876 Bovine/CBJ/Crossbreed 6 MILCH 25000
RED , RED MUTHUKUMARAN
Female ,
PUGAZHENTHI RED WITH Dr. M.
16 430079006655 Bovine/CBJ/Crossbreed 5 MILCH 25000
GOVINDHASAMI WHITE , RED MUTHUKUMARAN
WITH WHITE
Female ,
Dr. M.
17 INDRA KARUPPAIYAN 430079009702 Bovine/HFX/Crossbreed BLOCK , 7 MILCH 25000
MUTHUKUMARAN
BLOCK
CHITRA Female , Dr. M.
18 170251658914 Bovine/CBJ/Crossbreed 4 MILCH 15000
BALASUBRAMANIYAN RED , RED MUTHUKUMARAN
CHITRA Female , Dr. M.
19 430079004465 Bovine/CBJ/Crossbreed 6 MILCH 25000
BALASUBRAMANIYAN RED , RED MUTHUKUMARAN
Female , Dr. M.
20 PUNITHA VIJAYABALAN 430079004306 Bovine/CBJ/Crossbreed 6 MILCH 25000
RED , RED MUTHUKUMARAN
Female ,
Dr. M.
21 GEETHA SAKTHIVEL 170252703453 Bovine/CBJ/Crossbreed WHITE , 7 MILCH 25000
MUTHUKUMARAN
WHITE
SHAKTHIVEL Female , Dr. M.
22 430079008060 Bovine/CBJ/Crossbreed 5 MILCH 25000
UTHIRAPATHI RED , RED MUTHUKUMARAN
Female ,
Dr. M.
23 PALANIVEL SONAIYAN 170252703420 Bovine/CBJ/Crossbreed WHITE , 6 MILCH 25000
MUTHUKUMARAN
WHITE
Female ,
WHITE WITH
Dr. M.
24 KARPAGAM PALANIVEL 170252703293 Bovine/HFX/Crossbreed BLOCK , 5 MILCH 25000
MUTHUKUMARAN
WHITE WITH
BLOCK
Female , Dr. M.
25 NAGAVALLI CHINNAYAN 430079205697 Bovine/CBJ/Crossbreed 5 MILCH 15000
RED , RED MUTHUKUMARAN
Female ,
RED WITH Dr. M.
26 LALITHA SINGARAVEL 430079140498 Bovine/CBJ/Crossbreed 5 MILCH 25000
WHITE , RED MUTHUKUMARAN
WITH WHITE
Female , Dr. M.
27 ANDAL AYYAVU 430079009597 Bovine/CBJ/Crossbreed 4 MILCH 25000
RED , RED MUTHUKUMARAN
Female ,
BLOCK WITH
TAMILZHARASI Dr. M.
28 170251659590 Bovine/HFX/Crossbreed WHITE , 8 MILCH 25000
RAJENDRAN MUTHUKUMARAN
BLOCK WITH
WHITE
Female , Dr. M.
29 LATHA BALACHANDRAN 100042518415 Bovine/CBJ/Crossbreed 6 MILCH 15000
RED , RED MUTHUKUMARAN
Female , Dr. M.
30 LALITHA BALACHANDRAN 100042529402 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
CHANDRA SEKARAN Female , Dr. M.
31 430079152364 Bovine/CBJ/Crossbreed 6 MILCH 25000
VAITHILINGAM RED , RED MUTHUKUMARAN
CHANDRA SEKARAN Female , Dr. M.
32 430079152444 Bovine/CBJ/Crossbreed 6 MILCH 25000
VAITHILINGAM RED , RED MUTHUKUMARAN
Female ,
SIVABALANI RED WITH Dr. M.
33 170251673270 Bovine/CBJ/Crossbreed 5 MILCH 25000
CHANDRASEKARAN WHITE , RED MUTHUKUMARAN
WITH WHITE
Female ,
Dr. M.
34 MALA RAMACHANDRAN 170252703338 Bovine/CBJ/Crossbreed WHITE , 5 MILCH 25000
MUTHUKUMARAN
WHITE
MANIKANDAN Female , Dr. M.
35 170252703282 Bovine/CBJ/Crossbreed 7 MILCH 25000
RAMACHANDRAN RED , RED MUTHUKUMARAN
Female ,
BLOCK WITH
Dr. M.
36 SUDHA SINGARAVELU 430079004157 Bovine/CBJ/Crossbreed WHITE , 5 MILCH 25000
MUTHUKUMARAN
BLOCK WITH
WHITE
Female ,
Dr. M.
37 SUSILA VENUGOPAL 430079148781 Bovine/HFX/Crossbreed BLOCK , 6 MILCH 25000
MUTHUKUMARAN
BLOCK
Female ,
SARATHKUMAR Dr. M.
38 170252703418 Bovine/CBJ/Crossbreed BLOCK , 4 MILCH 25000
SATTANATHAN MUTHUKUMARAN
BLOCK
Female , Dr. M.
39 GEETHA NEDUMARAN 170252703271 Bovine/CBJ/Crossbreed 4 MILCH 10000
RED , RED MUTHUKUMARAN
RAJESWARI Female , Dr. M.
40 170252703134 Bovine/CBJ/Crossbreed 6 MILCH 25000
UTHIRAPATHI RED , RED MUTHUKUMARAN
Female ,
WHITE WITH
MANIKANDAN Dr. M.
41 170251663867 Bovine/HFX/Crossbreed BLOCK , 5 MILCH 25000
SATHASIVAM MUTHUKUMARAN
WHITE WITH
BLOCK

3/5
 Female , Dr. M.
42 BALAGURU MUTHAIYAN 170252703351 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
43 MALA GANTHI 170252703101 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
44 KALA RAMAMOORTHI 170252702893 Bovine/CBJ/Crossbreed 4 MILCH 15000
RED , RED MUTHUKUMARAN
Female ,
MANGAIYARTHILAGAM Dr. M.
45 170251660195 Bovine/HFX/Crossbreed BLOCK , 6 MILCH 25000
TAMILARASAN MUTHUKUMARAN
BLOCK
Female ,
Dr. M.
46 SELVARASU PONNUSAMY 170252703203 Bovine/HFX/Crossbreed BLOCK , 6 MILCH 25000
MUTHUKUMARAN
BLOCK
RATHIGA Female , Dr. M.
47 170251661677 Bovine/CBJ/Crossbreed 6 MILCH 25000
GANESHMORTHI RED , RED MUTHUKUMARAN
Female , Dr. M.
48 CHANDRAN RETHINAM 170252710960 Bovine/CBJ/Crossbreed 5 MILCH 25000
RED , RED MUTHUKUMARAN
Female , Dr. M.
49 GEETHA NEDUMARAN 170252703123 Bovine/CBJ/Crossbreed 4 MILCH 25000
RED , RED MUTHUKUMARAN

Tag should be surrendered at the time of claim,otherwise it will be treated as No claim.

In the event of death of animal/s covered under the policy, claim/s shall not be entertained unless the ear tag/s are surrendered to the
Company. In the event of loss of ear tag/s, it is the responsibility of the insured to give immediate notice to the Company and get the
animal retagged.
The Company is not liable to pay the claim in the event of death of insured animal due to disease occurring within 15 days from the
commencement of risk.
Total Sum Insured: 1135000 Net Premium : 19,295.00
CGST(0%) : 0.00
SGST(0%) : 0.00
UTGST(0%) : 0.00
IGST(0%) : 0.00
Stamp Duty : 1.00
Total : 19,295.00
Receipt No. : 10109110121106949047
Receipt Date : 01/10/2021

Agency/Broker Code:
Dev.Officer Code:

Location of the farm or place where the animals are stabled: FOH
Special Conditions /exclusions: ,NO TAG NO CLAIM

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Office Copy

Customer GST/UIN No.: Office GST No.: 33AAACU5552C1ZQ

SAC Code: 997139 Invoice No. & Date: 4721I106493860 & 01/10/2021
Amount Subject to Reverse Charges-NIL

Anti Money Laundering Clause:-In the event of a claim under the policy exceeding 1 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 JOIN THE FIGHT AGAINST CORRUPTION. PLEASE TAKE THE PLEDGE AT https://pledge.cvc.nic.in.

Date of Proposal and Declaration: 22/09/2021

IN WITNESS WHEREOF,the undersigned being duly authorised has hereunto set his/her hand at BO NAGAPATTINAM 091101 on this 01st
day of October 2021 .

For and On behalf of CONSOLIDATED

United India Insurance Co. Ltd. STAMP DUTY PAID AS
PER TAMIL NADU
GOVERNMENT G.O.
(RT.) No.222 DATED
10.07.2020 FOR THE
PERIOD FROM
01.04.2021 TO
Duly Constituted Attorney(s)
30.09.2021
Underwritten By - AMA45428 ( BO UW CUM CASHIER )

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