Bajaj Allianz General Insurance Company Ltd.

GE Plaza, Airport Road,Yerwada,Puna-411006(India)

CERTIFICATE CUM POLICY SCHEDULE
Policy Serving off: 3rd Floor,Lake City Plaza Karan Nagar, ,, ,, Srinagar-190010 Phone No : 0194-2471025/2482897
Policy Number OG-18-1205-1812-00000677 Prouct Commercial Vehicle – Package Policy
Vehicle type Passenger Carrying -4 Wh & CC >8 And 4 Wh & CC >17
Period Of Insurance From: 20-Mar-2022 :00 Policy Issued on 20-Mar-2022
To: 21-Mar-2023 Midnight Cover Note No /
Application No SDD.D3 D3/YU212 Security No 215679128
Insured Name MR. HAJI GHULAM AHMAD LONE Zone C
Insured Address WARAGAM KHANSAHIB
JAMMU & KASHMIR 191111 Premium Payer ID 47021238
Customer ID 407283070
Emp Code : BG145692

Transaction Id
HUPOTHECATED WITH: Policy Status ISSUED
Registration Make Sub Type Model CC Mfg Year Seat Vehicle/Trailer Chassis No Engine Number
NO. CAP
JK04C0352 TATA MAXI CAB SE PULS 1948 2013 7+1 J41714 713786

Vehicle IDV Elec Acc Non Elec Acc Trailer Trailer Reg No CNG/LPG Unit Total Sum Insurd
0 0 0 0 + 0
SCHEDULE OF PREMIUM
OWN DAMAGE LIABILITY
Total Own Damage Premium 2429.28 Basic Third Party Liability 13496.00
PA Cover For Owner- Driver of Rs. 200000 100
LL For Operation/Maintenance For 1 Person 50
Total Liability Premium 14897.00

Total Premium 13496.00

Special Discount 0

Net Premuim 13496.00

GST 2429.28

Surcharge 125
Final Premium Rs. 15925.28 *** All Premium Figures in Rupees

Geographical Area: INDIA No Claim Bonus : 45% Voluntary Excess : NIL

LIMITS OF LIABILITY : Under Section ll-1 (i) of the policy-> Death of the bodily injury:Such amount is necessary to meet there requirements of the Motor Vehicles Act,1988. Under
Section ll-1(ii) of the policy-> Damage to Third Party Property :Rs.750000/=
LIMITATION AS TO USE: The policy Covers use only under a permit within the meaning of the Motor Vehicle Act, 1988 or such a carriage falling under Subsection 3 of Section 66 of
the Motor Vehicle’s Act 1988.The Policy does not Cover use for :Organised racing, pace Making,Reliabillity Trials, Speed Testing.

DRIVER : Any person including the injured : Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or
Obtaining such licence. Provided also that the Person holding an effective Learner’s licence may also drive the vehicle when not used for the transport of passengers at the time of
The accident and that such a person satisfies the requirements of Rule 3 of the central Motor Vehicles Rules,1989.
IMPORTMENT NOTICE: The Insured is not indemnified if the vehicle is used or driven otherwise than accordance with this schedule, Any payment made by the
Company by reason of wider terms appearing in tne Certificates in order to comply with the Motor Vehicle Act,1988 is recoverable from the Insured. See the clause headed’’ A
VOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY’’.

Subject To IMT Endorsement Nos: 7,39 & Policy wordings attached herewith
Damage Details As per Annexure l
PREMIUM COLLECTION DETAILS :- [Reciept No/Collection No/ Amount] 1205-1831-000441000123200456/ Rs . 18798
*** If premium paid through cheque,the policy is void ab-initio in case of dishonour of cheque.
This certificate of Insurance is issued in accordance with the provision of Chapter X and Chapter Xl of M.V Act, 1988.
It is hereby understood and agreed that the purpose of application of Endorsement IMT-21 attached to and forming part of the above policy, the towing vehicle and trailer(s) while attached thereto shall be treated as single
unit.Damage Details Annexure: Nul PreinspectionNo :
In case of any claim, please contact our 24 Hour Cell Centre at 1800-22-5858, 1800-102-5858 (Toll Free) / 91-020-30305858
(Chargeable, add area code before this number in case of mobile call) or email us at ‘customercare@bajajallianz.co.in’.
48036564/-/100001119/1006-115/-
This is one page Policy Document[ without enclosing the Terms and Condition (T&C) of the policy] Issued by the company, pursuant to the authorization of Insured to display the T&C of the policy on its website (
www.bajajallianz.com) that enables access by the insured. The T&C of the policy are available on the Company’s website and can be accessed by the insured.
Kindly contact our nearest / local office(s) for No claim Bonus Confirmation.
For & Behalf of Bajaj Allianz Insurance Company Ltd.
Stamp
Duty Rs.
0.25

Authorized Signatory
Printed, Signed and Executive at Pune consolidated stamp Duty paid vide Receipt No: .2067 dated 20-Mar-2022
Regd.office plaza,Airport Road,Yerawada,Pune-411006(India),A Company incorporated uner India Companies Act,1956 and licensed by Insurance
Regulatory and Development Authority of India [IRDA] vide Reg No.113, corporate Identification Number U6610PN2000PLC015329.GST NO.011910513-
Latest Schedule 20-Mar-2022 15:17:08 PM (Web)