Two Wheeler-1 Year Own Damage Cover Bundled with 5 Years Liability Cover

Policy No. Issued at HERO INSURANCE BROKING INDIA PVT LTD.

United India Insurance Co. IRDA Registration No.: 649
04010031230160675476
M-13, 3rd Floor, Punj House Annexe, Connaught Place, New Toll-Free No.: 1800 102 4376
Delhi - 110001 264, Okhla Ind. Estate, Phase-III, Delhi-110020
Tel:1800 425 33333
040100@uiic.co.in

Insured Business/Profession Address of The Insured TP Valid From TP Valid To

Mr KALAMUDDIN . Employed S/O HADISH MIYAN VPO BADDI TEH BADDI DISTT S 07-12-2023 Midnight of 06-12-2028
OLAN Baddi HIMACHAL PRADESH 173205 17:09:57
Cubic GSTIN No.
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg
Capacity (Customer)
Hero MotoCorp SPL + BS6
New HA11E8PHL67575 MBLHAW234PHL99971 2023 100
DRSC
Declared Value (IDV) of Side Car IDV Non-Electrical Electrical Accessories CNG/LPG/Bi- Total IDV
Vehicle Accessories IDV IDV Fuel IDV
71250.00 NA 0.00 0.00 0.00 71250
Place of Regn. Body Type HP/Lease/Hire-Purchase Branch Office of Seating Premium
Agreement With HP/Lease/Hire-Purchase Capacity
Nalagarh Solo HDFC Bank Ltd., HPA --- 2 4812.00
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 358.00 Basic Third Party Liability : 3851.00
Non-Electrical-Fitting Premium : 0.00 TPPD Discount : 250.00
Electronic & Electrical Accessories : 0.00 Total : 3601.00
Bi-Fuel Kit : 0.00 CNG/LPG/Bi-Fuel Kit : 0.00
Geographical Extension : 0.00 Geographical Extension : 0.00
ND Cover : 119.00 Add
Less : Compulsory PA Cover (Owner Driver) : 0.00
Handicapped Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Un Named Driver) : 0.00
NCB : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Total Own Damage Premium(A) : 477.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 3601.00
Total Premium (A + B) : 4078.00
For any other extra : 0.00
IGST @ 18.00% : 734.00
Gross Premium : 4812.00
RegistrationNo.:103||LicenceNo.:103||CINNo.:U66010TN1938GOI003099||HSN/SAC:9971|| GSTIN No.:07AAACU5552C1ZL ||UIN No.-IRDAN545RP0011V01201819
OD Policy Period 07-12-2023 To 06-12- 07-12-2024 To 06-12- 07-12-2025 To 06-12- 07-12-2026 To 06-12- 07-12-2027 To 06-12-
2024 2025 2026 2027 2028
IDV 71250 NIL NIL NIL NIL
CPA Sum Insured(SCPA) NIL NIL NIL NIL NIL
Sum Insured of Optional PA Cover:-Sum Insured of Optional PA Cover "Unnamed Passenger"-NA and "Unnamed Driver"-NA
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 or
personal luggage) c) Organized Racing d) Pace Making e) Speed Testing f) Reliability Trials g) Any purpose in connection with Motor Trade.
DRIVER: Any person including insured: Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from
Holding or obtaining such a licence.Provided also that the person holding an effective Learner's Licence may also drive the vehicle and that such a person
satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act 1988. Limit of the
amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event : Upto Rs - 6000/
IMPORTANT NOTICE:--The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by
the company by reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the
clause headed 'AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY'
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with this provisions of Chapter X & XI of M.V. Act 1988
Broker : Hero Insurance Broking India Pvt. Ltd.
Premium of Rs. 4812.00 Received Vide CASH
Cash/Cheque No.
KADIRAN The policy is subject to a compulsory excess of Rs. 100/- &
Dated Nominee Name Depreciation is applicable as per policy terms & conditions*
BIWI
(Please turn overleaf for details)
Drawn on Nominee Age 47
Consolidated Stamp Duty Paid Endorsements : IMT - 22,20,5
Acknowledgement 07-12- Nominee Relation Mother
Dt 2023
FOR RENEWALS CONTACT: RAJVEER AUTO Ph.No- STD-9218548000 On behalf of United India Insurance Co. Ltd.

07-Dec-2023
Date & Signature of NEAR TOLL TAX BARRIER,PINJORE ROAD,DISTT-SOLAN
proposer

Dealer's Stamp & Signature Duly Constituted Attorney

# : Received with Thanks Rs 4812.00 from Mr KALAMUDDIN . as premium against the money receipt no 02U1120712202300783046
Regd. & Head Office : 24, Whites Road, Chennai 600014
For further information about motor insurance policy please also visit www.irdai.gov.in >> Grievances >> Policyholder Handbooks