s.

r vlc:41 Bra nch Add rea

a:
c ommercial unit No. 405
, Fou rth FIOOf , .3 & 6 -
500029 520 , "9hoka Sclntllla HI
. mayal Nagar Main Roa
Jul 09, 2019 el ,XO H YDE RAB AD H IMA
f AT IIAO/. R H f DUV•B -"D

Mr.SRIDHAR KOKKUL .
F NO 20 1 PLOT NO 1 SA
LAYOUT SA i NIVAS AP
i LAX MI Intermediary
GRUHA KALPA RO AD PR
TS RAJEE V
Code: O A5 00 912
RANGAREDDY ,TE LAN GAAG ATHI NA GAR
NA
500 030
Teleph one :
Intermediary
Mobile : 800841 4954 Name: MA YUR CHAN DAN
Contact:
9700 12 66 67
CERTIFICATE OF INSURA
(Se e Fo rm 51 of The
C e ntra l M otor Ve
NCE & poucv j
Cer tific ate ot Ins ura nce
and Pol ley No.
Pri vat e Ca r Pa kh ld = R I
ca ge poelj·cy
SCHEDULE
198 9) M oto r Veh ,d=
VPC 075 483 300 010 3 (Re pri nt] Ao. , ,oe e
Pol ley Pw lod : Per iod
I From 00:00:00 houra on ot l,_ IM'a nc. - -
21/0 7/20 111 To M idn
igh t Of 2CMJ7l2 020 -
IN SU RE D DE TA ILS
Nam e of Insu red
Insu red Dat e
of Birt h
Geo gra phical
Are a Occ upa tion
-\
Mr.SRI OH AA KO KKU L
.
India
\ ~a,m
Aut non t,
~ " " 7-
Dal e
\ R ANG ARE DO { \ H07 '20\ 4
IN SU RE D' $ DECLARED
For the VALUE (IDV) (ln Ra .)
Vehicle
For
Tra ller•
Non
Elactrl cal
Electrlcal / v.,... I
57 5.4 15 0
Ac c•e orlea
Ele ctro nlc
Acceaeorlea
o1 CNG
Kit
Tot al
IOV
Lo u
01
I

For Ltte
Tim e l ,~ 1
0 0 B■ aa■ ge Ro ed l'u Price
0 575 ,415 15,0 00
PR IVA TE CAR VEHICLE I 0
RealStration Number
TS0 7EA 61n
DETAILS
T ype at Bod v
' 0

EnQine Num ber
Cha ssis Num ber
Mak e ol 1he Veh icle
Model Des mp tioo
LIM ITA TIO NS AS TO USE
The Pol icy cov ers use of
a) H,re o r Rew ard ,
b) Ca rna ge ot goo ds (ot
r.,l O rg anis ed rao ng
d) Pac e mak ing
e) Spe ed tes ting
{) Rel,ab1hly T11als
Anv pur pos e in con nec
UM ll'S OF LIA BIL ITY :
l.klCler Section 11-1 (Q ol the
lXICler Section 11-1 {M) ol lhe
Personal Accident <XM
!r tor owner .
DEDUCT18LE: Total
Impose d OeductJ.ble [Rs. OJ nd Los s Of Bag gag e Deductr.ble{
I
D4F BDU 344 706 Sed an
Cub ic Cap acit y
1,58 2
M ALC U41 ULE M 171 541
F Yea r of Ma nufa ctur e
2014
H YUN DAI MO TOR S LTD
. Seating Cap acit y (ind udln I
a Driv er)
Flui dic Ver na 1 .6 CR DI
SX Tot al Pre miu m (In Ra .)
5
I
: 23,1 .
the ve hicl e for any p urp DRI VER :
ose othe r than : An y person includin g the
her tha n sam ples o r per )
Pro vide d that a pers on
Ins ure d
dr,v1ng holds an eftect1v
I
sona l lugg age lhe time of the acc iden & Or,v ,r.; Lctlf'Ct! d i
nbt;11nln g s11c h R License t and 1s not diSQua•tl6(} from hOl dng ·v
.
Pro vide d also that rhe pers
o n hold ing an eff9ct1ve
may als o dr,v o tho voh LtJ<jJner s l..Jc',-Vlo.J
ic lo c1nd tha1 s.t 1ct1 a
. . 1equi1 emtJOIS u f RultJ 3 ixv-..,on -.;1 1 \ tJ', ,.,.,
tion w11h Motor Trad e. uf Tl'ltJ Ct'Olic1I M t ,1, ~ V•-l
1'( .. , R .,, 1 "lc,
cl 0( bo<lly l~ury \
Poley · ~alh age Tlir d Part . s uch ll/0 0\n as ls necessary to meel the r~lr em ent
"C\.
\
y Property - Rs 750, 000 (as s
Policy . ~ r unde 10
r section 111: CSI · Rs.1,500 per IMT 20) - In respect ol anv ol lhe t.Aol()( Vehicles \968.
,000\- one clalm Of senes ol clialm
s 8l'tllnQ w don e ewr t
ded cfb le Rs 2 500 in resp
ect of eac h and every clai .
U 1 · • m . (Co mpu lsor y Ded uctible
/As 2,000}. Vol un tary Deducti.

Do cument Code:
a Rs. 500})

Ce rtili,ca te of ;nsurance & poli

ble (Rs . OJ.

cy sc hed u le co ntinued in
\
RA GW SV Z9K999 Pa ge 2
812235f1 511b1a20CJ8d670
07e45a71012

..• OU ._ ou ._ .... __ ~II • given bel

can ~ ue tnr gn u ,. ow M o n -
 (:1cte I 1) 1111 ti 1 01 I he Centr al M o1or VehlciM Rule• 1,.,,.9) M
p I • "" otor Vehtote1 Act 1966
r vate Car Package Polley [Reprint) ·
Polley No.VPC0754833000103 I
A • OWN DAMAGE p~:m In I . LIABILITY
1 Bas ic premium on Vehlole and N o n l tectnoal AOOtMlto11H
Pr.mtum In
◄ ,l\,N 00 1 1\11110 premium Including premium ror TPPO
A._
2 Bec1tloal & Elec1ronlo 1ooeuor1t11 ® ◄ %( 1M T Q◄ )
7 890 00
3 81-Fuol kit (CNG.ILPG) it!> ◄~11 (IMT 2~) 0 00 :> l • •: F01 I M 11 1Cled TPPD cover ror A1 e000 (IMT 20)
o oo ::I !Ji ruo t kl1 (CNOILM) 0 00
4 Traller1 (IMT30) 0 00
ADD :
ADD: 0 00
◄ Traller
6 Geographloal Area Ex,n Endt IM T- I
o oo Per9onal Accident Beneflll
0 00 15 Under Section Ill (Owner Driver). CS I Rs 1,500,000
e 30% 1or lmpolted vehld . . wllho\JI custom duty (IMT 19) 0 00 e Oeograph'°-1ArN El(ln Enctt IMT r
1 1500
0 00
7 Fibre OIH I T1nk1 O OO 7 Named PHNngers, cs, RI 0,00 ltl!Ch 119 per 1181
. , n., ched (IMT 1!5) 0 00
8 eo% 6n OD Pr&mlum tor On111ng Tul10n
9 MdlliOnal Towing Ch.lrgea Ra 0
10 f:01 any Olhei extra
ggg 6 Unnamed PaN enge111 , CS I Ra o each (IM'T 1e) O U)

LN•
0 00 9 P A Cover to Paid Orll/er , OSI Ra 0 ( IMl 17)
ADD :
or,o\
10 Di800unl IOI Anti ttten devlcel (IM f 10 )
0 00 legal Uablllty :
1 t AUIOmOble Auooa llon Dleoounl {IMT 8)
0 .00 10 To Paid D river (IM 'T 26) 50 001
12 Volunlllry Deduot1ble( IADA N 1();)A()O()jj V0 120011 10)1JI Rtl.0
( IM T 22 A)
13 50~ Oi9001.1n1 tor Vehlolee apeolally dealgnedlmodlfled
O.OO 11 . To Paid Employee• (IMT 29)
000\
101 blind .handicapped end mentally d'tellenged pen1on1 o.oo 12. For any o1her extra 0 00
t ◄ Vint ~ Car Dlaoo,.ui, 0 .00 13. TOTAL LIABILITY PREMIUM B a 56 001
15. Oeduct '20% No Claim Bonus -807 .80 14. Add: Underwriting Loading 'M. 0 00
11 . Add lklderwrltlnJi Loa~ _ _ _ _ __ 0 .00 15. NET PREMIUM A+ B 19 llSO 00 1
Add : Addfflo,-1 Cov.. for Pactu1ga PollclN
17 Depreoatlon Waiver (IAOAN1 02A00 11 V02201 2 13) 7,766.00
18 Wlnd9hleld Gian ( I ROA N1 02AOOO◄ V01200llt0) 0 .00
19 FaalltieS 1n Ueu ol Spare Car (I A01'Nt 021'0007V01 2001110) 0 .00
20 Full lnv010e Pr1oe lnsuranoe (ll'VANt02A0008V012001110) 0 .00 ADD: SGST 1 7e9 .JO
21 Ule Time Road Tax { IROAN1 02A0005V012001110) 0 .00 ADD: CGST I 7e9 CO
22 lDN ~ Baggage { IAOAN1 02AOOOIIV012001110) 120.00
23 NC B PrOl.ectOI C Oiier (IROAN102A0002V0120 1314) 0 .00
2◄ Aggravation Cover (l!'VAN1 02Aooo1vo1201314) 0 .00
25 Key Repil!IOefflenl Cover ( IRDAN1 0? A000 1V01;>011i 16)
276.00
215 T re CcNer C\auae 1ROAN102A0003V01 20 1718 0 .00
27 . TOTAL OWN DAMAGE PREMIUM
;.:,;;..,,:,...
A,__ _ _ __,__11 ,395.00 11. TOTAL PREMIUM PAYABLE
Ko Clalnl 6on1a. ::S
• l Koo..,, ~ w ■ any ba ~ proll!Oa<I the policy 11 , -wed wlhlri GO dllVII ot lhe expiry dale Ol lhe pnivloue Yffl. b) The lneured II enNlllt<l IOt • No Claim 8oow (NC I
on - Own o.m.g. Seclon 01 tha polcy , I no Cllllm .. ma<II or pendlnQ dur1ng !he preoedlng ye■ r(I) , H per lhe dellllle gl\len below

,c, 011 NC8 on 00 Pr ■mlum

Subjecl lo IMT [ ndl Noa. A Memora not.,, 2tl, 7 A RSM(MC I I I f
(refer Tem 11 A Cunr1n1<v11 lor - vanl WOltli"IQJ
?O l 11l<14!1 ►tire Purch!l<Ol!A"""' A11reemenl lt-fYI'<~ "'' " HOH ' SANK l ro
Nomln• Name :omlne■ AIJ'I 1 R.l■ llonilllic, -
Ouardlan N■me O uardll■n •~ ~ IMIIUllln R.Maooo
0

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In Wilnfow wr••··~ j lllil Pr..,, hH r.i-n !llgfl"ll 81 r l1f'flrt.i ••l ()Ql(J/f/0 IU lr t '"'" " ' (k !W'r ll1Jh1 N,, (1/!1.,(1 " ""' '' · N,, l1W,t her,itJy ,-.irl!l'i lf'tl\11"" f'\'41CY "-' w l\lt'II ll'rl
Certllcale rellrMI U we l 1.1 ll .. (.,el1.#IC4lle IA lfltlUfft l lOIII 8111 IN ou(I hi 8 (l()(JI O/l(lfltl wl lt 11111 rrn11l8 k1111 i ~ 1'11• ~ 111 )( lll tJ <'11111•111 ;,,;1'" ""' ~"-"'-~ v - ~ ~ -'ct. ' ~
IMJJ OO JA.141 11 0 r I( r ,,. ,,, ,,, , I /I•,, ,,.,. '""''" d ,, "" v,.n"" ,. "'"' ",,, dnv, •n 1ilh.1M ,.,, ,,..,,1111 {ti. , tid.atk .. n ,,, "'" ' ~ ,,._, ... t' ---\~ l\H ~ " '"'-- ('\, fltt l ..... , ......... :"\
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or CE FH A.11>1 ri r,MJ ANC1111<,111 u, 111 r,n v, 11 Y ,,.,,,,. 1•,J,, r ' " '"'" " " ' ' ( ,11, N ti""•
t o, Ruy■i iiun<lllr■m o.n.-111 I M<ir ■nOII Co. um1-,

Co n■ol ld■ l■d a tamp Duty Paid kl Ou vl of l ■mllNlld u

1hi ■ docurn ■lll la 1.llgtllllly •1',1..a, h<t1w • oo unllN a1g,-..iur. t ■l■n\P le not requlr■d .
GS'TIN 3eAABCA7 I oec3 1ZK
UIN lllD AN I O~POOO<IVU'.l.'0 16 1f PAN Nun1ber AABC R7 10eO
For Legal lnterprelallon , Engll1t't ve111lon wMI hOld good
e22alf1 1 19b1 ■200edl7007 -◄ le71012

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