Servicing Office: IFFCO TOKIO GEN INSUR CO LTD, 3RD FLOOR, OFFICE NO.

32-33, WHITE CASTLE OVER MTNL EXCHANGE, UNION PARK

Regd. Office: IFFCO Sadan C1 Distt. Centre, Saket, New Delhi - 110017
COMMERCIAL VEHICLE CERTIFICATE OF INSURANCE cum SCHEDULE

IFFCO-TOKIO GENERAL INSURANCE CO. LTD

MUMBAI MAHARASHTR INDIA Agent Name Agent #: Agent Mobile #:

400074

Insured's Name MOHD BABU AHMED SAHEB SHAIKH Address: PLT 10 GANESH APT KALHER BHIWADI THANE ( AUTO) Pin Code 400000 THANE INDIA Cover Note # : Phone#: 0000000000 Insured Motor Vehicle Details & Premium Calculation Registration Mark & No. MH04DK5869 Year of Org. Sale/Year of Manuf. 2008 Type of Body APE PIAGGIO Make of Vehicle ICVCLASS C.1B 3WHEELED VEHICLE CC Coverage IDV in Rs.

Policy # : 1-G9JYOX Date of Issuance : 18/01/2012 Period of Insurance : From: 18/01/2012 : 14:24:00 To : Midnight on 17/01/2013 00:00:00 Geographical Area : Within India Only

Engine No. 90384 Chassis No. 542815 7

Seating Capacity

GVW

195

Act Only

Registration Authority : Vehicle 1.00 Trailer 0.00 Non Electrical Access. Elec./Elect. Acc. 0.00 0.00 Bi-Fuel Kit 1.00 Total Value 2.00 Net Premium Rs. 2697.00 2360.00 0.00 60.00

A. Own Damage (Rs.) Basic OD Premium Basic Trailor OD Premium Electrical/Electronics Accessories (IMT 24) Bi Fuel Kit (IMT 25) Fiber Glass Fuel Tank Add : Geographical Area Extension (IMT 1) Overturning Extensions( IMT 47) Hire Reward/Commercial Usage (IMT 44) IMT 23 Driving/Tuitions (0)

B. Third Party (Rs.) 0.00 Basic TP Premium 0.00 Basic Trailers TP Premium (IMT 30) 0.00 Bi Fuel Kit (IMT 25) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Add : Geographical Area Extension (IMT 1) PA Owner Driver PA Paid Driver/Cleaner/Conductor (IMT 17) Legal Liability to Driver (IMT 28) LL to Non Fare Paying PAX (IMT 37) LL To PAX on Ambulance/Hearses (IMT 46) LL to Employee (IMT29)

(1) (0) ()

0.00 0.00 25.00 0.00 0.00 0.00 0.00 0.00 0.00 2445 2445.00 252.17 2697.17

Less : Anti Theft Device (IMT 10) Handicap Discount (IMT 12) Vehicle User (IMT 13) No Claim Discount Any Other Loading/Discount Net (A) Co-Insurance Details Co-Insurer 1 Co-Insurer 2
Subject to IMT Endorsement Nos., 20, 17, 25, 27

Less : 0.00 Third Party Property Damage (IMT 20) 0.00 Limit of Liability Under Section II-I (ii) 0.00 ( 0.0% ) ( 0.0% ) Agent No./Share No Co-Insurer! No Co-Insurer!
NA Printed herein / attached

0.00 0.00 Any Other Loading Discount 0.00 Net (B) Total Premium (A + B) Service Tax/GST Premium Paid Rs.

Under Hire Purchase /Hypothecated/Lease Agreement with Limitation as to use :

Use only in Connection wit insured's business. Use only for carriage of passengers in accordance with the permit (Contract Carriage or Stage Carriage) instead within the meaning of the Motor Vehicles Act The Policy does not Cover: 1. Use for Organised racing, pace making, reliability trail or speed testing 2. Use whilst drawing a trailer except the towing (other than reward) of any one disabled mechanically propelled vehicle 3. Use for the Conveyance of passenger for hire or reward by any person to whom the Motor Vehicle is hired Private Car type vehicles let out on private hire and driven by hirer or any driver with hire permission. 4. Use for the conveyance of passenger for hire or reward, other than the guests of hotel. Private Car type vehicles owned by hotels and hired by them to their guests

Passenger Carrying Vehicles - Class C

Driver Clause :
Any person including insured: provided that the person driving holds and effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license. 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 of the The Central Motor Vehicles Rules, 1989.

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 during the preceding year(s) as per the following Period of Insurance Percentage of NCB on OD Premium Limit of Liability The preceding year 20 % Under Section II-I(i) Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988 Preceding two consecutive year 25% As per premium computation table Under Section II-I(ii) Preceding three consecutive year 35% Under Section III PA Owner- Driver as per premium computation table Deductible under Section I Preceding four consecutive year 45% Preceding five consecutive year 50% Goods Carrying Vehicles No claim bonus will only be allowed, provided the policy is Not Exceeding 7500 Kg. GVW 500/- : Rs. 500/renewed within 90 days of the expiry date of the previous Taxis and Three Wheelers rated as Commercial Vehicles (Exceeding 1500 cc) : Rs. 1000/policy.

Receipt Particulars Cash / Cheque : CASH Amount : 2697.00 Bank Details :

S.Tax.No. D-III/ST/R-IV/GEN.INS./01/03 Dated :

For IFFCO-TOKIO General Insurance Co. Ltd.

Authorised Signature.

Note-: 1)"Policy Issuing Office: Delhi" 2)" Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi" FOR CLAIMS CALL 1800 103 5499(Toll Free),0124-4285499 or SMS"CLAIM" to 56161

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