Go Digit General Insurance Limited Schedule/Certificate

Digit Commercial Vehicle Liability Only Policy

UIN No.: IRDAN158RP0001V01201718

Policy Number D081065849 / 31102022 Issue Date 31-Oct-2022

Period of Policy From 01-Nov-2022 19:17:47 Mobile xxxxxxxxx7199
To 31-Oct-2023 23:59:59 Email sxxxxxxxxxxxxxxxxxxxxxxx8@gxxxl.com
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CGST GSTIN Unregistered GST State Code 29
BN
Name NARAYAN R Partner Code 1069216
POLICYBAZAAR INSURANCE BROKERS
Partner Name
657 HALDENAHALLI PO, BESTAMARANAHALLI, PRIVATE LIMITED
Address Partner Contact --
ANEKAL,BENGALURU,BENGALURU-562106
AN Partner Email customerservice@pbpartners.com

MA
FH Registration, Policy Type
Make CubicCapacity/Power Registration/ Trailer Reg.
1 Engine, Model Fuel Type GVW Manufacturing No. IMT Endorsements
G65 Year
Chassis No. Variant Body Type Licensed Capacity

N Public
KA53MA9229 JCB 3437 CC 2013
Carrier

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MAK IMT-28,IMT-3,IMT-
LicensePlate

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Po
N H00020657 3 DX 2WD Diesel 7640 Kg 47(Overturning
Number:-
covered),IMT-7

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Earth Moving BACKHOE --

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1817390 1
Mechine LOADER

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Premium Details

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Third Party Liability Premium (Including CNG) (`) 7309.00

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Legal Liability for Paid Driver (Persons:1)(`)
MAKL 50.00

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KH Net Premium al
` 7359.00
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Pri CGST @ 9% = (`662.31 ) + SGST/UTGST @ 9% = (`662.31 ) ` 1324.62

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Total Premium ` 8683.62

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7309
Dies ENDORSEMENT
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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium
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IA078543217 2022-10-31 7317.00 0.00 658.53 658.53 0.00 0.00 8634.06

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IA081549034 2022-12-06 0.00 0.00 0.00 0.00 0.00 0.00 0.00

01
1-

IA081620433 2022-12-07 42.00 0.00 3.78 3.78 0.00 0.00 49.56

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22

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Nominee Details
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D

--
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CGST
Misc D Previous Insurer Policy Exp.
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Name: -- Policy Number: -- Date: --

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3
B
JC

Details provided for this endorsement are true and correct. Any discrepancy shall render the
endorsement invalid. I do hereby confirm that details being entered by me for this endorsement are
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true and correct. I have verified these details with the customer/against documents. In the event of
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any discrepancy, the Company shall remain entitled to take appropriate action against me,
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including legal action.

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Following are the financial endorsements changes:

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FirstName: NARAYAN
Die
R

Other Details LastName: R

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Mobile Number: 9741907199

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Email id: SRIMANYATOURSANDTRAVELS68@GMAIL.COM

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Street: HALDENAHALLI PO, BESTAMARANAHALLI, ANEKAL

A

Location: BENGALURU
N

01/0 Zipcode: 562106

City: BENGALURU
State: KARNATAKA
Odometer
FASTag Number NA
Financier Details MANAPPURAM FINANCE LIMITED

FASTag NUMBER DECLARATION

PolicyNumber :-D081065849
Page No :-1 of 2
 Go Digit General Insurance Limited Schedule/Certificate
Digit Commercial Vehicle Liability Only Policy
UIN No.: IRDAN158RP0001V01201718
The Policy has been issued subject to your affirmative declaration that a valid FASTag has been affixed on the insured vehicle.

Geographical Area - Any accidental loss damage and/or liability caused sustained or incurred within India shall be covered subject to Policy Terms and
Conditions, unless specifically agreed and endorsed. Limitation as to use - Use in connection with the insured's business.The Policy does not cover (1) Use
for racing, pace making, reliability trial or speed testing.(2) Use for the carriage of passengers for hire or reward.(3) Use whilst drawing a trailer except the
towing (other than for reward) of any one disabled mechanically propelled vehicle. Person or class of persons entitled to drive - Any person including the
insured 1) Provided that a person driving holds an valid and effective driving license at the time of the accident and is not disqualified from holding or
obtaining such a license. 2) Provided also that the person holding an vaild and effective Learner’s license may also drive the vehicle and that such a person
satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and any subsequent amendment as applicable. Limits of Liability - Under
Section II - 1 (i) of the policy - Death of or bodily injury: such amount is necessary to meet the requirements of Motor Vehicle Act, 1988 and any subsequent
amendment as applicable Under Section II - 1 (ii) of the policy - Damage to Third Party Property ` 750000 P.A. Cover under Section IV for Owner - Driver
(CSI): ` 0
PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of your declaration that
you do not hold a valid Driving License on or before the date of commencement of this Policy / already have an alternate Personal Accident insurance cover
of Rs. 15 Lakhs
Important Notice : 1) *Cheque dishonor / Non-receipt of payment: If premium paid through Cheque, the policy is void ab initio in case of dishonor or non-
receipt of payment. 2) Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of Chapter X and Chapter XI of MV act, 1988
subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 3) This policy is subject to the standard policy
wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff 4) Policy would be void on the ground that it was obtained
by non- disclosure of material fact or by a representation of fact which was false in some material particular. 5) The insured is not indemnified if the vehicle is
used or driven otherwise than in accordance with this Schedule. Any payment made by Company for reason of wider terms appearing in Certificate in order
to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the Clause headed (Avoidance of Certain Terms and Right of Recovery). in

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the policy.

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PUC Declaration:The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of

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commencement of the Policy.

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For & On Behalf of Go Digit General Insurance Ltd.

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Consolidated Stamp Duty has been paid as per Letter

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of Authorization No.67-B/04/2017-18 Date: 30th May

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Authorized Signatory 2017 issued by Department of Stamps and

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Praveen Bhat Registration , Bengaluru- 560009 - KARNATAKA.

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Senior Vice President - Customer Experience HSN: 997134/General Insurance Services In

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praveen.bhat@godigit.com
Hey, our document is now digitally signed
Printed, Signed, and Executed at Bengaluru
al Click here to view the certificate.
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For instant resolution, you can ping us “Hi”
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on WhatsApp at 702 606 1234

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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. A
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Company incorporated under Indian Companies Act, 2013 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Reg No.
D

158, Corporate Identification Number U66010PN2016PLC167410 | GST Reg. No.: 29AACCO4128Q1ZW GSTIN Address: Bangalore Broker Business
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Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-560095
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In case of claim or any other query, please contact our 24-hour Call Centre at 1800-258-5956 or email us at hello@godigit.com or visit our website
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www.godigit.com.
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PolicyNumber :-D081065849
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