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ORIGINAL FOR RECIPIENT/DUPLICATE FOR SUPPLIER.

TAX INVOICE/CERTIFICATE CUM POLICY SCHEDULE
(FORM 51 OF THE CENTRAL MOTOR VEHICLES RULES, 1989)
Policy Type Stand-alone OD Policy ( Private Vehicle ) Proposal No. & Date
Policy No. & Type 34280031230160126196 Period of Insurance
Policy Issued On 15-Apr-2023 (00:00) Vehicle Identification No.
Insured Name Mr. Dileep Kumar Yadav Geographical Area
Invoice No 23MI60126196 Accounting Code of Service
S/O RAMESH CHANDRA YADAV WARD NO-1 YADAV BASTI RAJPUR DUNGARPUR ,,
Insured Address
DUNGARPUR-314001, Rajasthan
Insured State & Code Rajasthan-08 Place of Supply Rajasthan GSTIN of Customer
INSURED MOTOR VEHICLE DETAILS INSURED DEC
Make Maruti Vehicle
Model & Variant NEW ALTO VXI/MARUTI ALTO VXI 0.8L 5MT Non Electrical Accessories
Registration No RJ12CB2297 Electrical Accessories
Year of Manufacture 2021 CNG/ LPG Kit
Engine- Chassis No 6513046 - MA3EUA61S00H66533 Total IDV
Cubic Capacity 796
Seating Capacity 5
Type Of Body Saloon
RTO Location RJ12CB2297 / DUNGARPUR
Schedule Of Premium (Amount in Rs.)
OWN DAMAGE SECTION (A) Pre-Existing Thir
Vehicle 3137 Insurance Company Name
Elec. Accessories 0 Policy No.
Risk Inception Date
Non- Elec. Accessories 0
Risk Expiry Date
Kit (IMT-25) 0
Extra Premium towards Inbuilt CNG/LPG NA MISP - TECHNOY MOTORS INDIA PVT LTD
Basic Premium 3137
Geographical Area Extn. (IMT-1) NA Notes : ( For Stand-alone OD Policy )
Lamp, Tyres etc. (IMT 23) 0
Driving Tuition Loading On OD Premium (60%) NA 1. Policy Issuance is the subject to the reali
2. Consolidate stamp duty paid to State Exc
Fiber Glass Tank 0 3. The Policy is subject to a compulsory De
Sub-Total Additions 0 4. Voluntary excess Rs (0)
5. Subject to Endorsements IMT ,7 10,
Deductibles 6. The Coverage under this policy is only
Voluntary Deductibles (IMT 22A) 0 connection with the vehicle.
7. OD Premium rates are different for NCB
Anti-Theft Device (IMT-10) 78
NCB to Non-NCB, the recoverable amou
AAI Membership (IMT-8) 0
No Claim Bonus (25%) 765
Discount for vehicles designed for handicapped NA
Sub - Total Deductibles 843

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Add - On Coverages
NIL DEPRECIATION 1911
Engine And Gear Box Protection 546
Return To Invoice 683
Net own Damage Premium (A) 5434
IGST@18% 978.12
Total OD Premium 6412
Nominee Details : Nominee Name RAMESH YADAV Age
Payment Method Cheque No./Transaction No. Bank Name
Payment Detail
MasterCard Credit Card 112852923451
Financier Type Financed Financier Name MAHINDRA AND MAHINDRA FINANCIAL SERVICES L
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 o
making, e) Speed testing, f) Reliability Trials, g) Any purpose in connection with Motor Trade.
Driver: Any person including the insured, Provided that a person driving holds an effective driving license at the time of the accident and is not disqual
Provided also that the person holding an effective learner's license may also drive the vehicle and that such a person satisfies the requirements of Rule 3 o
Deductibles: Deductible under section-I : Rs 1000(Compulsory Deductible Rs 1000 Imposed Deductible Rs. 0 and Voluntary Deductible Rs 0)
No Claim Bonus: The insured is entitled for a No Claim Bonus (NCB) on the Own Damage section of the policy, if no claim is made or pending durin
preceding year/20%, Preceding Two consecutive years/25%, Preceding Three consecutive years/35%, Preceding Four consecutive years/45%, Preceding
only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
IMPORTANT NOTICE: The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any paym
appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE
RECOVERY". For Legal interpretation, English version will hold good.
For information on ombudsman you may visit website : http://www.gbic.co.in/ombudsman.html
I / We hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance with the provisions o

Policy Issuing Office:-B- 39, Inner circle, Conaught Place, New Delhi -110001
GSTIN: 07AAACU5552C1ZL, CIN No.:U93090TN1938GO1000108
State Name : Delhi

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