Standard Fire and Special Perils

UIN: IRDAN158CP0005V01201819
Quote/ Proposal form
a) This proposal will be the basis of the insurance policy that we issue. You must disclose all facts relevant to al

Policy Details:
Quote Number D040231242 From 01-Aug-2021
Period of Insurance
Policy Tenure 365 days To 31-Jul-2022

Intermediary 1004025 Intermediary Contact +918886858589ravikanth@pragmaticinsurance.com

Code and Name PRAGMATIC INSURANCE and Email ID
BROKING SERVICES PRIVATE
LIMITED

Insured Details
Name & Address of the ARTHOS BREWERIES LIMITED PAN --
Insured/Proposer 14-A-20/1, DRAKSHARAMAROAD,
RAMACHANDRAPURAM, East Godavari,
Andhra Pradesh 533255
GST State Code 37 GSTIN/UIN Unregistered
Number
Contact No Email ID

Name of Bank/ Financial

Institution

Coverage Details
Item Description Total Sum Insured (INR)

Building/Structure Including Plinth 60000000

Contents 640000000

STFI Opted

Earthquake Opted

Terrorism Not-opted

Location-wise Details

Location 1

Description Breweries
s

e all facts relevant to all property(ies) proposed to be insured that may affect the Company’s decision to issue a policy or

0:00:01

23:59:58

nth@pragmaticinsurance.com

istered
Address of Premises 14-a-20/1, draksharamaroad, ramachandrapuram, east godavari, andhra pradesh East Godavari 533

PIN Code 533255 City

Occupancy Type Breweries Height

Name of Bank/Financial Age

Institution
Fire Fighting Fire Extinguisher in premises Construction
Arrangements (Pucca/Kutcha)

Total Sum Insured - 700,000,000

Plinth & Machinery & Stocks F&F & Other Other Property
Building Foundation Accessories Stocks (WIP) Equipments to be Insured
Specifically

60000000 580000000 60000000

Add-ons Location 1

Sr. No Add-On UIN

Add-on 1 Insurance of Additional Expenses of Rent for an Alternative

Accommodation IRDAN158CP0005V01201819/A0019V01201819

Add-on 2 Architects, Surveyors and Consulting Engineers Fees (in

excess of 3% of the claim amount) IRDAN158CP0005V01201819/A0027V01201819

Impact Damage due to Insured's own Rail/Road Vehicles, Fork

Add-on 3 lifts, Cranes, Stackers and the like and articles dropped IRDAN158CP0005V01201819/A0011V01201819
therefrom

Add-on 4 Removal of Debris (in excess of 1% of the claim amount) IRDAN158CP0005V01201819/A0028V01201819

Add-on 5 Forest Fire IRDAN158CP0005V01201819/A0010V01201819

Add-on 6 Escalation Clause IRDAN158CP0005V01201819/A0026V01201819

Add-on 7 Omission to Insure additions, alterations or extensions IRDAN158CP0005V01201819/A0013V01201819

Add-on 8 Temporary Removal of Stocks Clause IRDAN158CP0005V01201819/A0017V01201819

Endorsements & Clauses:

Sr. Limit of Indemnity /
No Add-On/Clause UIN Aggregate Amount (INR
(Where ever Applicable)
1 Designation of Property Clause IRDAN158CP0005V01201819/A0023V01201819

2 Waiver of Underinsurance IRDAN158CP0005V01201819/A0079V01201819 5 % of the SI

3 STFI Cover 700000000

4 Fire Extinguishing / Fighting Expenses IRDAN158CP0005V01201819/A0052V01201819 35000000

5 Seventy-Two Hours Clause IRDAN158CP0005V01201819/A0090V01201819

6 Archives IRDAN158CP0005V01201819/A0081V01201819 100000

7 Earthquake IRDAN158CP0005V01201819/A0014V01201819 700000000

8 Reinstatement Value Policies IRDAN158CP0005V01201819/A0024V01201819

9 Errors and Omissions IRDAN158CP0005V01201819/A0056V01201819 35000000

10 Plans, Documents and Computer Systems IRDAN158CP0005V01201819/A0083V01201819 100000

Records

11 Property of Employees and Visitors/Personal IRDAN158CP0005V01201819/A0073V01201819 35000000

Effects

12 Expediting Costs IRDAN158CP0005V01201819/A0036V01201819 35000000

13 Sprinkler Up-Grading Costs IRDAN158CP0005V01201819/A0039V01201819 35000000

14 Cost of Re-Writing Records IRDAN158CP0005V01201819/A0042V01201819 100000

15 Immediate Repairs IRDAN158CP0005V01201819/A0050V01201819 35000000

16 Expenses for Loss Minimization IRDAN158CP0005V01201819/A0040V01201819 35000000

17 Cyber risk exclusion clause

18 Involuntary Betterment IRDAN158CP0005V01201819/A0054V01201819 35000000

19 Pair and Set/Consequential Reduction in Value IRDAN158CP0005V01201819/A0051V01201819 35000000

20 Damage to Building (Occasioned by Theft) IRDAN158CP0005V01201819/A0055V01201819 35000000

21 New Location Cover IRDAN158CP0005V01201819/A0048V01201819 50000000

22 Property Under Care Custody and Control IRDAN158CP0005V01201819/A0049V01201819 0

23 Sanctions Limitation and Exclusions Clause

24 Local Authorities Clause IRDAN158CP0005V01201819/A0025V01201819

i, andhra pradesh East Godavari 533255

East Godavari

11

Pucca Construction

Number of
Loss of Rent Months

Max Sum
Insured

35000000
1819/A0019V01201819

50000000
1819/A0027V01201819

1819/A0011V01201819 35000000

1819/A0028V01201819 35000000

1819/A0010V01201819 35000000

1819/A0026V01201819 35000000

1819/A0013V01201819 35000000

1819/A0017V01201819 0

Limit of Indemnity /
Aggregate Amount (INR)
(Where ever Applicable)

5 % of the SI

700000000

35000000

100000

700000000

35000000

100000

35000000

35000000
35000000

100000

35000000

35000000

35000000

35000000

35000000

50000000

0
 Additional Risk Information
Details of Business Covered at the location
If used as warehouse / godown (located outside the factory
compound) please give the list of goods stored
If used as an Industrial Manufacturing unit, state the details of
products manufactured at the location proposed (detailed block plan
showing various facilities to be enclosed)
If used as an Industrial Manufacturing unit, please state whether the
factory is working or silent?
Is there a water body near the Premises proposed for Insurance?
If Yes, please mention the type of Water Body - Ocean, Sea, River, Lake &
the distance between with the water body and the Premises:
Is the Ground Level of the Premises Equivalent to Sea Level?
If No, is it above or below, please specify:
Has there been any Natural Catastrophe near the Insured Area?
If Yes, please share when this event occurred?
Are any Hot or Electrical Works Performed in the Premises?
If Yes, please confirm if it is performed in a confined area or not and whether
electrical wiring present or not.
Fire Load Assessment

Whether the Building/Structure is of Class A Construction.

(Class A Construction means where the Building has Roof made up of RCC
and Wall are Buildup of Brick with RCC Frame).
If Yes, please confirm if it is performed in a confined area or not and whether
electrical wiring present or not.
Please provide the details of the Security System in the Premises:

Is there a Safety Training Programme for the Employees/Occupier of

the Premises
If Yes, what is the frequency of Safety Training?
If yes, is the trainer External or Internal:
Please specify the Type of Electrical Wiring used:

Please specify the Housekeeping Practices

Applicable Excess
This Excess shall apply per location
This Policy does not Cover (Not applicable to Policies Covering Dwellings with Individual Owners)

Policy Having Sum Insured up to INR 10 Crore per Location - Commercial

Entity only and not dwellings
Policy Having Sum Insured above INR 10 Crore per Location up to INR 100
Crore per Location
Policy Having Sum Insured above INR 100 Crore per Location up to INR 1500
Crore per Location
Policy Having Sum Insured above INR 1500 Crore per Location up to INR 2500
Crore per Location
Policy Having Sum Insured above INR 2500 Crore per Location
ation

ndividual Owners)

5% of the Claim amount subject to minimum

of Rs 10,000/
5% of the Claim amount subject to minimum
of Rs 25,000/
5% of the Claim amount subject to minimum
of Rs 5,00,000/
5% of the Claim amount subject to minimum
of Rs 25,00,000/
5% of the Claim amount subject to minimum
of Rs 50,00,000/
 Warranties
FEA Warranty - Warranted that Fire extinguishing appliances (Portable Hand Appliances/Hydrant System/Sprinkler System) which a
1 installed in the insured premises shall be maintained in efficient working condition at all times with trained manpower available to
operate the same at the premises
2 Warranted that there are Nil Claims for last 3 Years

3 No Smoking Warranty - Warranted that smoking is prohibited in the premises covered under the policy

4 Electrical Installation Warranty

5 Kutcha Construction Warranty - Warranted that no structure is of kutcha construction in the insured premises

6 Warranted that the premises has no basement or basement is only being used for Parking.

Premium and Payment Details:

Net Premium (INR) - (a) 889017.50

Total Terrorism Premium (INR) - (b) 0.00

Endosment Premium (INR) - (c) 0.00

Total Net Premium (a) + (b) + (c) 889017.50

CGST rate and amount (INR) --

IGST rate and Amount (INR) 18%

Kerala flood cess rate and Amount(INR) --

Final Premium (INR) 1049040.65

Cheque No/NEFT Ref No Bank Name Date Amount (Including applicable taxes)

Declaration
• I/We, hereby declare that the statements and particulars given in this Proposal form are complete, true and accurate and I/We agree tha
Insurance company will not be liable under the insurance contract if it is found that any of my/our statements or particulars or declarations
proposal form or other documents are incorrect /misleading /Fraudulent in any respect on any matter to the grant of a cover or submission
in future.
• I/We hereby agree to receive all monies due from the Company by way of refund of premium, claims etc. into my/our bank account / pa
mode as specified in the instrument / electronic transaction tendered towards insurance premium and such electronic transfer will constitu
final discharge of Company’s obligation.
• I/We further declare that l/we will notify in writing any change in the details so furnished hereinabove occurring after the proposal has be
submitted but before communication of the risk acceptance by the Company.
• I/We authorize the Company to share information pertaining to my proposal for the sole purpose of proposal underwriting and/or claims
settlement and with any Governmental and/or Regulatory authority.
• I/We hereby agree and undertake that I/we are agreeable not to receive the hard copy of the Policy and related documents Yes/ No.
Date
Place Signature of the Proposer
Declaration from Person filling the form in case proposer is unable to sign or signs in vern
I hereby certify that the contents of the proposal form and/or any other documents used towards solicitation have been fully explained to
Proposer and that he/ she/they have fully understood the said contents. I hereby confirm that the responses have been recorded to the b
ability.
Date Signature of the Proposer
Place Relationship with Proposer
This proposal form has been electronically accepted

INSURANCE ACT 1938 SECTION 41- Prohibition of Rebates

No person shall allow or offer to allow either directly or indirectly, as an inducement to any person to take out or renew or continue an in
in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any reba
premium shown on the policy, nor shall any person taking out or renewing a policy accept any rebate, except such rebate as may be allo
accordance with the published prospectus or tables of the insurer. ANY PERSON MAKING FAULT IN COMPLYING WITH THE PROVISIONS O
SECTION SHALL BE PUNISHABLE WITH FINE WHICH MAY EXTEND TO TEN LAKHS RUPEES.
Go Digit General Insurance Ltd, A Company incorporated under Indian Companies Act, 2013 and licensed by Insurance Regulatory and D
d Appliances/Hydrant System/Sprinkler System) which are
ndition at all times with trained manpower available to

es covered under the policy

onstruction in the insured premises

sed for Parking.

0.00

160023.15
--

Amount (Including applicable taxes)

orm are complete, true and accurate and I/We agree that the
t any of my/our statements or particulars or declarations in this
pect on any matter to the grant of a cover or submission of claim

d of premium, claims etc. into my/our bank account / payment

rance premium and such electronic transfer will constitute full and

urnished hereinabove occurring after the proposal has been

the sole purpose of proposal underwriting and/or claims

d copy of the Policy and related documents Yes/ No.

Signature of the Proposer

oser is unable to sign or signs in vernacular
nts used towards solicitation have been fully explained to the
y confirm that the responses have been recorded to the best of my

Signature of the Proposer

Relationship with Proposer
ctronically accepted

ohibition of Rebates
ent to any person to take out or renew or continue an insurance
the whole or part of the commission payable or any rebate of the
cy accept any rebate, except such rebate as may be allowed in
MAKING FAULT IN COMPLYING WITH THE PROVISIONS OF THIS
S RUPEES.
es Act, 2013 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Reg No. 158, Corporate Identification Number U66