THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

CERTIFICATE OF INSURANCE UNDER CATTLE/LIVESTOCK MASTER POLICY

Pandit Deen Dayal Upadhyaya Samoohik Pashudhan Bima Yojna(PDDUSPBY)

UIN NUMBER - IRDAN190RP0179V01100001

Insured Name : MANOJ KUMAR
Insured's Details Issuing Office Details
Customer ID : POA8703417 Office Code : DO FARIDABAD (312700)
Address : PONKAR KHERI Address : NH-5/R-2 NR BADSHAN KHAN CHOWK
NIT, FARIDABAD
GVH-Ramrai ,121001
RAM RAI ,HARYANA, 126110
Phone No : XXXXXX1964 Phone No : 01292415167
E-mail/Fax : / E-mail/Fax : nia.312700@newindia.co.in /
PAN No : S.Tax Regn. No : AAACN4165CST178
GSTIN/UIN : NA / NA GSTIN : 06AAACN4165C2ZU
: SAC : 997139 (Other non-life insurance
services excl RI)

Policy Details
Policy Number : 31270047232700055337 Business Source Code
Period of Insurance : From: 07/10/2023 12:00:01 AM To: Dev.Off : Hindustan Insurance Brokers Ltd. -
06/10/2024 11:59:59 PM level./Broker/Corp. (DM2460074)
Agent/Web Hindustan Broker_312700 -
Aggregator/CPSC User (SI00147570),
Date of Proposal : 07-Oct-23 Agent/Bancassurance/S :
pecified Person
Prev. Policy no. : Phone No : NA / NA
Client Type : E-mail/Fax : insurance@hibl.in, / /
Type of Policy : Scheme Excess : 0

Premium GST (`) Total (`) Total (` in words) Receipt No. & Date
(`)
0 7,600 RUPEES SEVEN THOUSAND SIX HUNDRED 31270081230000288503 - 09/10/23
7,600 ONLY

POLICY SCHEDULE OF CATTLE

Details of the Insured Cattle
Sl. Origin of Cattle Identification Purpose Sex Breed/Color/ Age in Years Sum Name of Propose Location
No risk Type Tag No. of Use Other Marks & Months Insured Owner/Be r ID of Stable
neficiary
1 Indigeno Milch 1600070154 Milk Fem MURRAH/BL 5 Year 0 80000 MANOJ 113679 PONKAR
us Buffaloes 05 ale A Months KUMAR 9 KHERI
CK `PONKAR
KHERI
JIND
2 Indigeno Milch 1009091903 Milk Fem MURRAH/BL 5 Year 6 80000 MANOJ 113679 PONKAR
us Buffaloes 83 ale A Months KUMAR 9 KHERI
CK `PONKAR
KHERI
JIND
3 Indigeno Milch 1002903758 Milk Fem MURRAH/BL 5 Year 0 80000 MANOJ 113679 PONKAR
us Buffaloes 02 ale A Months KUMAR 9 KHERI
CK `PONKAR
KHERI
JIND
4 Indigeno Milch 1009000054 Milk Fem MURRAH/BL 5 Year 0 80000 MANOJ 113679 PONKAR
us Buffaloes 07 ale A Months KUMAR 9 KHERI
CK `PONKAR
KHERI
JIND

Signature Not
Verified
Policy No. : 31270047232700055337Document generated by HLDB at 09/10/2023 19:53:50 Hours.
Digitally signed
by JAGATJAYEE Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
PANIGRAHI Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
Date: 2023.10.09
For redressal
19:53:50 IST of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own
grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website
http://newindia.co.in.

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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

5 Indigeno Milch 1600457999 Milk Fem MURRAH/BL 5 Year 0 80000 MANOJ 113679 PONKAR
us Buffaloes 57 ale A Months KUMAR 9 KHERI
CK `PONKAR
KHERI
JIND

SI.No Permanent Total Disability(PTD) Transit Cover(TRA) Migration Cover(MIGR)

1 NO NO NO
2 NO NO NO
3 NO NO NO
4 NO NO NO
5 NO NO NO

Name of the Veterinary Doctor/Hospital Registration No. & Address

SI.No
1 Ramrai,JIND

Financier/Bank details HDFC,JIND

Type of Agreement Hypothecation

Specific Conditions : NA,NA

1) Death due to Diseases contracted prior to and within 21 days of commencement of risk is not payable.
2)NO TAG NO CLAIM. Tag shall be surrendered intact at the time of claim otherwise it will be treated as No Claim. In the event
of death of cattle covered under the Policy claim/s shall not be entertained unless intact Ear Tag/s are surrendered to the
Company.
In the event of loss of ear tag/s it is the responsibility of the Insured / Beneficiary to give immediate Notice to Company and
get the cattle Re-tagged through Qualified Veterinarian under intimation to Company /Broker office.
3)In case of death of the Cattle immediate intimation must be given to Company / Brokers Office.
4) In case of accidental death of the cattle intimation to police authorities is must.

NOTE: WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY
CANCELLED 'AB-INITIO'.

Premium and GST Details

Rate of Tax Amount in INR
Premium ` 7,600
SGST 0 0
CGST 0 0
IGST 0 0

In witness whereof the undersigned being duly authorised by the Insurers and on behalf of the Insurers has (have) hereunder
set his (their) hand(s) on this 09th day of October,2023.

For and on behalf of

The New India Assurance Company Limited

Duly Constituted Attorney(s)

Mudrank_____________Dt.___________consolidated Stamp Fees Paid by Pay Order Number_______________vide receipt

number___________dt.__________.

Stamp Duty under the Policy is ` 1

Policy No. : 31270047232700055337Document generated by HLDB at 09/10/2023 19:53:50 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own
grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website
http://newindia.co.in.

Page 2 of 3
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

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.

Tax Invoice No : 31270023P0070630

IRDA Registration Number: 190

NIA PAN NUMBER: AAACN4165C

Policy No. : 31270047232700055337Document generated by HLDB at 09/10/2023 19:53:50 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own
grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website
http://newindia.co.in.

Page 3 of 3