Reliance Two Wheeler Policy - Bundled 

Policy No. Issued at HERO INSURANCE BROKING INDIA PVT LTD.

Reliance General Insurance Co.Ltd. IRDA Registration No.: 649
993792223750201532
Plot no C44, Man Upasana building, 6th floor, Sardar Patel Toll-Free No.: 1800 102 4376
Marg C - Scheme. Jaipur- 302001 264, Okhla Ind. Estate, Phase-III, Delhi-110020
Tel:18003009
customercare@reliance-hdi.co.in

Insured Business/Profession Address of The Insured TP Valid From TP Valid To

Mr VIKASH KUMAR Agriculture S/O KHYALI RAM VILLAGE SANWALSAR DEIDASPU 21-12-2022 Midnight of 20-12-2027
RA, GANGANAGAR ARJUNSAR RAJASTHAN 305804 18:10:41
Cubic GSTIN No.
Vehicle Regn No. Engine No.  Chassis No. Make & Model Year of Mfg
Capacity (Customer)
Hero MotoCorp
New HA11EDN4L43923 MBLHAW128N4L31931 SPLENDOR + BS6-I3S 2022 97
DRS
Declared Value (IDV) of Side Car IDV Non-Electrical Electrical Accessories CNG/LPG/Bi- Total IDV
Vehicle Accessories IDV IDV Fuel IDV
70073.00 NA 0.00 0.00 0.00 70073
Place of Regn. Body Type HP/Lease/Hire-Purchase Branch Office of Seating Premium
Agreement With HP/Lease/Hire-Purchase Capacity
HERO FINCORP LTD,
Ganganagar Solo --- 2 5051.00
HPA
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 470.00 Basic Third Party Liability : 3851.00
Non-Electrical-Fitting Premium : 0.00 TPPD Discount : 250.00
Electronic & Electrical Accessories : 0.00 Total : 3601.00
Bi-Fuel Kit : 0.00 CNG/LPG/Bi-Fuel Kit : 0.00
Geographical Extension : 0.00 Geographical Extension : 0.00
Nil Depreciation Cover : 210.00 Add
Less : Compulsory PA Cover (Owner Driver) : 0.00
Handicapped Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Un Named Driver) : 0.00
NCB     : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Total Own Damage Premium(A) : 680.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 3601.00
Total Premium (A + B) : 4281.00
For any other extra : 0.00
CGST @ 9.00% : 385.00
SGST @ 9.00% : 385.00
Gross Premium : 5051.00
1.RegistrationNo.:103||2.LicenceNo.:103||3.CINNo.:U66603MH2000PLC128300|| GSTIN No.:08AABCR6747B1ZG ||UIN No.-IRDAN103RP0008V02201819||IRDAN103RP000
8V01201819/A0060V01201819
21-12-2022 To 20-12- 21-12-2023 To 20-12- 21-12-2024 To 20-12- 21-12-2025 To 20-12- 21-12-2026 To 20-12-
OD Policy Period
2023 2024 2025 2026 2027
IDV 70073 NIL NIL NIL NIL
CPA Policy period(NODL) NIL NIL NIL NIL NIL
LIMITATIONS AS TO USE:--The Policy covers use of the vehicle for any purpose other than: a) Hire Or Reward b) Carriage of goods (other than samples or
personal luggage) c) Organized Racing d) Pace Making e) Speed Testing f) Reliability Trials g) Any purpose in connection with Motor Trade.
DRIVER: Any person including insured: 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 a licence.Provided also that the person holding an effective Learner's Licence may also drive the vehicle and that such a person
satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act 1988. Limit of the
amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event : Upto Rs -  6000/
IMPORTANT NOTICE:--The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by
the company by reason of wider terms appearing in the 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 RIGHTS OF RECOVERY'
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with this provisions of Chapter X & XI of M.V. Act 1988
Description of services :--The insured is Motor vehicle insurance services.
Broker :  Hero Insurance Broking India Pvt. Ltd.
Received Vide
Premium of Rs. 5051.00  
Cash/Cheque No. The policy is subject to a compulsory excess of Rs. 100/- &
KRISHNA Depreciation is applicable as per policy terms & conditions*
Dated Nominee Name
DEVI (Please turn overleaf for details)
Drawn on Nominee Age 42 Consolidated Stamp Duty Paid Endorsements : IMT - 22,20,5
Acknowledgement 21-12- HSN 9971
Nominee Relation Mother
Dt 2022
FOR RENEWALS CONTACT:  RAJESH BHADU  Ph.No- 0967-2540163 On behalf of Reliance General Insurance Co.Ltd.

21-Dec-2022
Date & Signature of
proposer

Dealer's Stamp & Signature Duly Constituted Attorney

# : Received with Thanks Rs 5051.00 from Mr VIKASH KUMAR as premium against the money receipt no 02Y122122019670
Regd. & Head Office : Reliance General Insurance Company Limited, 6th Floor, Oberoi Commerz, International Business Park, Oberoi Garden City, Off
Western Express Highway, Goregaon (East), Mumbai – 400 063 
Reliance ISO Certified Company-An ISO 9001:2015 Certified Company. Consolidated Stamp duty Paid vide Letter of Authorization No LOA
NO.CSD/411/2022/ (Validity Period from Dt. 21/07/2022 to Dt. 15/07/2023)/3178 DT. 17/08/2022 at General Stamp Office, Mumbai. ** Not Applicable for
the State of Jammu & Kashmir
For further information about motor insurance policy please also visit www.irdai.gov.in >> Grievances >> Policyholder Handbooks