Insured's Address Policy Issuing Office Address

Insured's Name: UTTAM ORGANIC FERTICHEM IFFCO TOKIO GEN INS CO LTD, 1st Floor,
PTV.LIMITED . Commerce House 7, race course Road, New
Address: 201, THE MAGNET, Palasiya, Near 56 shops INDORE, MADHYA PRA
6/1, NEW PALACIA, PIN CODE:452001-INDIA
, Phone#:4270270
INDORE, MADHYA PRA - 452001 Agent#: 22000666
Agent Name:LANDMARK INSURANCE
Phone#: NA BROKERS PVT
MOTOR POLICY RENEWAL Agent Phone#:9538002227
NOTICE Tie-up Code 22001271

Date: 11/06/2015
Subject: Notice for Renewal of Motor Insurance Policy no. 88355576 valid till 13/07/2015 for Vehicle No. MP09CN1638

Dear Valued Customer,

We thank you for choosing IFFCO TOKIO General Insurance for your Insurance needs. We wish to inform that your policy for captioned vehicle is falling due for
renewal. The details of vehicle are as under:-
Registration Year Of Type Of Engine No. Seating
Model/Type of Vehicle GVW
Mark & No. Manuf. Coverage 100A20000295877 Capacity
Chassis No.
MP09CN1638 2013 TATA INDICA VISTA QUADRAJET 9 Package NA 5
MAT611450CLJ16065
RENEWAL IDV Breakup:-
Premium Payable
Vehicle Trailer Non Elec. Acces. Elec. Acc. Bi-Fuel Kit Total IDV
(Inc S.T.)
491640.00 0.00 0.00 0.00 0 491640.00 14511.92
Additional Loading
B. Third Party
A. Own Damage
T.P. Liability Premium(B) 1748.00
Total Premium (A) +(B)+(C) 12729.76
Own Damage Premium(A) 10981.76
Service Tax (14%) 1782.16
C. Additional Coverage Premium(C) 0.00 Net Premium 14511.92
Additional Coverage marked as only are included:- 1= Personal effect & belongings 2= NCB protection 3 =New Vehicle replacement
4= Dep. waiver 5 = Increased property damage 6= Towing & related 7= Transport,Redelivery 8= Wreckage/Debris
9= Medical Exp 10= Daily rental/Travel Cost 11= PA Value Auto-Insured persons 12= PA Value Auto-Owner driven
13= Acc. Exp 14= Loss of Income (CVI)

PLEASE NOTE:-
1. In case of claim on or before expiry of current policy, renewal premium will be `14303.16
2. To ensure continuity of your policy, kindly renew before expiry date failing which an inspection of your vehicle will have to be done at the time of renewal and the inspection/survey fees
would have to be borne by the insured.
3. You are requested to remit renewal premium through Cheque/DD drawn in favor of "IFFCO-TOKIO General Insurance Co. Ltd" before the expiry of the policy to your agent or to above
mentioned policy issuing office directly or to Retention Cell at Corporate Office (address mentioned below).
Thanking you for placing your trust and confidence in IFFCO TOKIO and assuring you of our best attention at all times.

Authorized Signatory
(IFFCO-TOKIO General Insurance Co. Ltd)
-----------------------------------------------------------------------Tear this portion and attach with Cheque/DD----------------------------------------------------------
Insured Name: UTTAM ORGANIC FERTICHEM PTV.LIMITED . Policy Number: 88355576 Renewal Premium Amt: ` 14511.92

Information Update From: In the event you notice any mistake in personal contact or vehicle details, please fill in correct details in form below and send it to us with
your Cheque/DD.You can also update your information by visiting our website www.iffcotokio.co.in and register with us or SMS CONTACT to 56677 to receive a
call back from our customer care or simply email at support@iffcotokio.co.in
Customer Name :-____________________________________________________Vehicle Registration No.:-___________________________
Address:- ______________________________________________________________________City:- Pin:-____________
Phone # (Land-Line):- ________________________Mobile #:-____________________Email ID:-_____________________________________
88355576
Signature of the Policy Holder