7113922, 358 AM ‘THE NEW INDIA ASSURANCE CO. LTD. {Goverment of Incia Undertaking) ‘share_pd_exportpeget.png BY) POLICY SCHEDULE FOR EMPLOYEES COMPENSATION INSURANCE ‘UIN NUMBER - IRDAN190P0077100001 Toe tice Dewae Cantor iD zfPosr+ 12582 [tice Code sJoarcuTta D0 1510900) i [pcos + [oT No sawSt BANGASADONA [Adios ISUMA ESTATE. ZNO FLOOR. 7,GANESH| TORTS NTE Sion leniiaa AveAUe [Arai NewTORN KAVARNA | 00013 ay KOLKATA WEST BENGAL, 100156 Es [Phone no Thxxoooxs249 Phere No fossazaraso 1 ‘EmalFax erawvony epansiionsom. [Emel + Jna.5100008 ewnae.caan PANN. T]xsacuoaee [Tax Rog No. + [aaacnanesesTire 1 [esmuuns :fngaAACLOSWOETZN NA lost faAAACNet65c1Z0 | : [sac 7 37138 (omer non-We newanoe sivees foxy Om THR, DEDASISH SANA -(@ATOTTETED =] re-Mayz2 TAgeneBancassurance/S || 118 Sais DASGUPTA Peclles Person Iiiasovor72s24)AGENT_SITE_otae1) ovoraoz2) + Jsvovonaea voro0000002 [Prone No + Josszzzszes0, yoaswoes00, 9951000773 a51082000 + ewGargarae Eman ane. nast0s00R yanca a na 108008 yanoo Zon [csr Total (©) Total in words) & Date 35252 217855 RUPEES TWO LAC | p00008922050021269| SEVENTEEN THOUSAND] "2" 1305/22 EIGHT HUNDRED FIFTY i Vee eee 7 CHT FIVE ONLY = | etal of Employeus with monthly wages unto ® 15000: [ Categories Fi ‘Sub Categories Ngof_ | Cash Total ‘lider: Al employees engaged in shop or ‘Exc. blasting and tunneling 707 | 47523600 Yard or tn construction! demolition af | ullaings and other etal construction like ‘dares, bridge ete incl excavation DDetals of Emplayees with monthly wages above 15000; Page aia71322, 959 AM snere_pat_exporipege2.pag ‘SerialNo | Name of, Description ‘Catagorta ‘No, of Workers ‘Amount Wages | | contractor T ‘Statied [Unsidiled] Others j ‘eto ner meal cae i Name of the Extension [ Sub Limit of the Extension | Deductibles of the Extension orm ae ; POU geal ms | (Special Exclusions [wa eee rT SSS ae annie commoner Raye NTRS Ce ee eer tee ec pga ater ret amaatn car : sae Fs : : i ithein Pamala) on th “{Stn gay of ay 2022. Ferand on beha of “The New tnd Assurance Company Liited [Bote of aaa. 1305/2022 Di, ARUP KUMAR BISHYAS) (Bk: Dre MANAGER! Duly Constituted Atromeyia) Stamp Outy under the Foley 1s & uarank, ot, consolidated Stamp Fees Paid by Pay Order Number, vide receipt umber ‘Tax Invoice No : 51090022P0000888 Policy No: 6togooss2am1 eo00d90sDocimant generated by GR RENEWAL ot 1408/2022 17:51:40 Houre. Regd. & Head Offtce: New india Asouranco Bldg, 87 4.6. Road, Fost, Manbal- 400 001. TOLL FREE No, 1 800 2091416, Pagezot3118122, 3:09 AM share_pa_exporipages.png ‘THE NEW INDIA ASSURANCE CO. LTD. {Govommont et india Uncertakieg) IRDA Registration Number: 190 AAACNA165C. Poey No: st090096220100¢00004Document gaverated ky OR_RENEWAL at 1908/2022 17:61:49 Hout, gd & Head Ofte: New nda Assurance Bg, 87 M.G. Road, Fort, Mumbal -400 001. TOLL FREE No.1 00 209 1416. Page So's