Office Copy

UNITED INDIA INSURANCE COMPANY LIMITED

NO.153, 1ST FLOOR,"GURU ARCADE", ZONE-I, MAHARANA PRATAP NAGAR BHOPAL, BHOPAL,
MADHYAPRADESH
BHOPAL - 462011 MADHYA PRADESH
PHONE: (0755) 2763447 FAX: EMAIL:

ALL RISK INSURANCE POLICY

POLICY NO.:1911001223P106257915

PERIOD OF INSURANCE
From 00:00 Hrs of 02/09/2023
To Midnight of 01/09/2024

Insured
MR SUNIL DHANGAR
E-7, SAI BOARD 11NO STOP , BHOPAL
462016
BHOPAL
MADHYA PRADESH
IMPORTANT NOTICE: KINDLY UPDATE YOUR AADHAAR NO. AND PAN/FORM 60. PLEASE IGNORE IF ALREADY UPDATED.

Agent Name : JAYA CHAUHAN

Agent Code : AGD0128288
9424486133
Mobile/Landline Number/Email :
jaya8374@gmail.com

The genuineness of the policy can be verified through "Verify Your Policy" link at www.uiic.co.in.

For any Information, Service Requests, Claim intimation and Grievances please write to 191100@uiic.co.in

Download Customer App(www.uiic.co.in). REGD. & HEAD OFFICE, 24, WHITES ROAD, CHENNAI - 600014.
Website: http://www.uiic.co.in
Printed By : CUSTOMER @ 04/09/2023 10:59:52 AM

This document is digitally signed

Signer: KALAIVENI SUBBIAH

Date: Mon, Sep 4, 2023 11:00:02 IST
Location: United India Insurance Company Ltd
1/3 Reason: Signing Policy for UIIC
Office Copy

ALL RISK INSURANCE POLICY

SCHEDULE
Policy No: 1911001223P106257915 Previous Policy Number
Name Tel.(O) FAX.
Insured Details /ID Tel.(R) Mobile 8120199516
MR SUNIL DHANGAR / 23241828680
Email DHANGARS249@GMAIL.COM
Period Of Insurance From 02/09/2023 00:00 To Midnight of 01/09/2024

Coinsurance :- UIIC 191100 : 100%

Occupation/Business None
Geographical Limit India
Previous Policy Number

Item Wise Details:-

Item Serial No Name of Items Description Sum Insured( )
LENOVO I5 IP3 KYIN IIG I5, 8GBN PF325EW6 Others LENOVO I5 IP3 KYIN IIG I5, 8GBN PF325EW6 53,354.00

Total Sum Insured 53,354.00

Sl No Cover Name Premium( ) Sum Insured( )

1 Basic Cover 693.60 53,354.00

Premium 694.00
Additional conditions (if any):
CGST(9%) 62.00
SGST(9%) 62.00
Stamp Duty 1.00
Total 818.00
Receipt No. 10119110023107106043
Receipt Date: 01/09/2023

Agency/Broker Code: AGD0128288

Dev.Officer Code:

* Loss due to theft or disappearance of any insured article i.e laptop when left unattended in
any vehicle or place excluded. In case of Theft, FIR is mandatory.* Accident arising out of
Negligence, Mishandling, water damage is not covered. * Larceny, INVENTORY LOSS,
MYSTERIOUS DISAPPEARANCE ARE EXCLUDED. * The Articles are not to be handed over on good
faith to any person. * Any repair or replacement will be undertaken in India only and the claim
will be settled in Indian currency only. The loss will be settled on Market value basis.* The
detailed list of the equipment should be attached to the policy schedule with all specifications
Special Condition
including values of each individual item. * Breakages and / or scratches to the screens not
covered unless the equipment totally damaged. * Loss of data/software/consequential loss of
any kind is not covered.* Mechanical & electrical breakdown excluded. * Breakdown risk is
excluded. ** Sum Insured to be taken as current replacement value i.e. value of new laptop.**
Total loss claims to be settled on Market Value Basis or Sum Insured whichever is lesser.** For
Partial loss claims, no depreciation to be applied on parts replaced.** Deductible : 5% of the
claim amount subject to min. of Rs. 500/- for each & every claim.

The laptop shall be used only BY: (USER NAME-MR. SUNIL DHANGAR, M.NO. 8120199516) * Loss
due to theft or disappearance of any insured article i.e laptop when left unattended in any
vehicle or place excluded. In case of Theft, FIR is mandatory.* Accident arising out of
Negligence, Mishandling, water damage is not covered. * Larceny, INVENTORY LOSS,
MYSTERIOUS DISAPPEARANCE ARE EXCLUDED. * The Articles are not to be handed over on good
faith to any person. * Any repair or replacement will be undertaken in India only and the claim
will be settled in Indian currency only. The loss will be settled on Market value basis.* The
Underwriting Remarks detailed list of the equipment should be attached to the policy schedule with all specifications
including values of each individual item. * Breakages and / or scratches to the screens not
covered unless the equipment totally damaged. * Loss of data/software/consequential loss of
any kind is not covered.* Mechanical & electrical breakdown excluded. * Breakdown risk is
excluded. ** Sum Insured to be taken as current replacement value i.e. value of new laptop.**
Total loss claims to be settled on Market Value Basis or Sum Insured whichever is lesser.** For
Partial loss claims, no depreciation to be applied on parts replaced.** Deductible : 5% of the
claim amount subject to min. of Rs. 500/- for each & every claim.

Customer GST/UIN No.: Office GST No.: 23AAACU5552C1ZR

SAC Code: 997137 Invoice No. & Date: 1223I106257915 & 01/09/2023
Amount Subject to Reverse Charges-NIL

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We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the
aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said
sub-rule.
Anti Money Laundering Clause:-In the event of a claim under the policy exceeding 1 lakh or a claim for refund of premium exceeding
1 lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company's web site.

LET US JOIN THE FIGHT AGAINST CORRUPTION. PLEASE TAKE THE PLEDGE AT https://pledge.cvc.nic.in.

Date of Proposal and Declaration: 02/09/2023

IN WITNESS WHEREOF,the undersigned being duly authorised has hereunto set his/her hand at DO 2 BHOPAL 191100 on this 01st day of
September 2023 .

For and On behalf of

United India Insurance Co. Ltd.

Affix Policy
Stamp here.

Duly Constituted Attorney(s)

Underwritten By - MOH33179 ( DO UW CUM CASHIER )

This is a system generated document and any manual alteration / correction / overwriting in the document will make it invalid.

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