CERTIFICATE OF MOTOR INSURANCE

30 day ­ Scooter H&R inc SDP

1. Certificate number:
Work provider customer number:
ZEIC30/2423NK
2. Registration mark of vehicle: 7MOXS
PE22 HZM
3. Name of Policyholder:
Jucelina Costa Berg Dos Santos

4. Effective date of the commencement of insurance for the purpose of the relevant law:
15/01/2024, 11:04
5. Date of expiry of insurance:
13/02/2024, 23:59
6. Persons or classes of persons entitled to drive:
Provided that the person driving holds a licence to drive the vehicle or has held and is not disqualified for or prohibited by
law from holding or obtaining such a licence
Insured Only: Jucelina Costa Berg Dos Santos

7. Limitations as to use:
Business use for the transportation of goods for Hire and Reward (fast food delivery and parcel / package delivery)
including whilst working for DELIVEROO.

Social, domestic and pleasure purposes

8. Exclusions:
­ Use whilst the vehicle is let on hire
­ Use while carrying pillion passengers
­ Use for any racing, pacemaking, contest, reliability or speed trial
­ Use for any purpose in connection with the motor trade

I hereby certify that this certificate satisfies the requirements of the relevant Law applicable in the United Kingdom, the Channel
Islands and EU countries or countries approved, by the EU commission to comply with the First Directive on Motor insurance.

Extracover Insurance Company Limited,

1st Floor Grand Ocean Plaza,
Ocean Village,
Gibraltar

This policy has been underwritten by Extracover Insurance Company Limited. Extracover Insurance Company Limited, P. O. Box 1338, 1st Floor Grand Ocean
Plaza, Ocean Village, Gibraltar. Registered in Gibraltar Company Number 118662. Licensed and regulated by the Gibraltar Financial Services Commission.
Extracover Insurance Company Limited is part of the Zego Group of companies whose parent company is Extracover Holdings Limited (a company registered in
England & Wales with company number 11187061).

Note: For full details of the insurance cover, reference should be made to the Antilo Policy, Schedule and Endorsements.
Advice to third parties: Nothing contained in this certificate affects your right as a third party to make a claim.
 IMPORTANT NOTES

If you have any enquiries regarding your insurance, please contact the broker/agent who arranged your insurance. These notes
do not form part of you Certificate of Motor Insurance. Your Certificate of Motor Insurance is an important document. If it is
incorrect you are liable to prosecution, so please check it very carefully.

Please keep this Certificate of Motor Insurance safe.

1. You should notify your broker immediately if you:

a. Change the Insured Vehicle or obtain an additional vehicle. {Notification is a condition of your insurance.}
b. Require a change in the use of the vehicle.

2. Your broker must also be notified as soon as possible of any change in circumstances affecting the insurance:
a. Any modifications or engine conversion to your vehicle.
b. Change of address.
c. Change of drivers.
d. Any convictions.
e. Any pending prosecutions.
f. Any physical or mental defect, including heart conditions, diabetes, epilepsy, disabilities or infirmities.
g. The prescription of permanent medication.
h. Additional audio or communication equipment.

If you have any doubt as to whether or not to tell us of any fact, please contact the broker/agent who arranged your insurance
for advice

Cancellation

Should this policy be cancelled, this certificate must be returned. The cancellation will only be operative from the date of receipt
of the certificate.