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Endorsement Schedule: LC0000000619 Intermediary Code Name M/S.Policybazaar Insurance Brokers Private Limited
Endorsement Schedule: LC0000000619 Intermediary Code Name M/S.Policybazaar Insurance Brokers Private Limited
GSTIN : 06AAJCS4517L1Z2
Email_id : care@policybazaar.com
Endorsement Effective : From 18:34 On 04/02/2022 To Midnight Of 21/01/2023
It is hereby agreed and declared that the gender of the insured person(s) covered under this policy shall be read as mentioned hereunder and not as stated in
the schedule of the policy. 1. Insured Name: Ananya Basavaraj Mudakannavar Gender: Female 2. 1. Insured Name: Aadya Basavaraj Mudakannavar
Gender: Female
Warranted that in case of dishonour of premium cheque(s) the within mentioned policy stands cancelled from inception and the company absolves all liabilities under the
Policy/Endorsement.
In witness whereof the undersigned being authorised by and on behalf of the company has herein to set his hand at Branch Office - Gurgaon III on 04th Day of February 2022.