THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Commercial Vehicle Package Policy

UIN Number -

Insured's Details Policy Details

Insured's Name: MR. AMIT KUMAR MAHESHWARI S/O Policy number: 45110331170100008490
RAMGOPAL MAHESHWARI
Customer ID: PO61717794 (PAN No :NA) Period of cover: 24/07/2018 01:01:29 PM to 30/03/2019
11:59:59 PM
Insureds Address: PIPLIYAMANDI, MANDSAUR,,, Registration no. MP-44-P-0157
MANDSAUR - 01 S.O ,MADHYA PRADESH,
458001
Prev. Policy no. 152605/31/2017/8440 Make/Model: TATA MOTOR/BUSES
Email: Receipt no. 45110381180000002803 - 24/07/18
Phone Number : / / 7828414242 Fax Number : NA / NA

GSTIN/UIN NA / NA
Issuing office New India Contact
Address NEEMUCH BRANCH (451103), Agent / Corp. Agent /
1ST. FL., ABOVE CENTRAL BANK OF INDIA , KAMAL Broker / Banc Mr. Deepak Sharma -
CHOWK, , , Assurance / Referral
MADHYA PRADESH , 458441. Code - Name / (NIAAG00029759)
POS/IMF/SPECIFIED
PERSON
Phone no 9753633979 / 07423221830 / 8602131214
Phone no 07423403806 / 07423221830 Fax no. /
Fax no. 07423403815 / NA Email sharma.deepak2907@gmail.com /
nia.451103@newindia.co.in
Email nia.451103@newindia.co.in Development officer SUNIL GWANDE - (2D10673305)
level Name/Code
Claim Contact NEEMUCH BRANCH (451103) Claim Contact Detail 1ST. FL., ABOVE CENTRAL BANK OF INDIA,KAMAL
CHOWK,,;07423403806/07423221830/
GSTIN 23AAACN4165C1ZZ
SAC 997139 (Other non-life insurance services excl RI)
Policy Details
Geographical Area / Zone: India/C Year of manufacture: 2009
Type of Commercial Vehicles: C - Passenger Carrying Sub Type: C2-Four Wheeler(Carrying >6)
Name of the Financier: AU SMALL FINANCE BANK LTD Chassis no./Engine no.: 386518CQZ805868/497TC93CQZ8081
52
Type of fuel: Diesel Cubic capacity ( cc): 3783
Type of body: Bus Gross Vehicle Weight (GVW): 0
Seating capacity including Driver: 34 Variant: TATA LP 709 EX/42 PASSENGER
BUS
Automobile Association Colour: NOT SPECIFY
membership:
Cover Note No/Cover Note Issue / Name of registration authority: Neemuch - MP 44
Date:
Transit From NA Transit To NA Distance Covered NA
IDV(In `) Based on annexure-I
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
450000 0 0 0 0 450000
Schedule of Premium
Own Damage Liability
Basic OD Cover Basic TP Cover
Legal liability to passangers, LL to paid
driver conductor cleaner employed for
oprn

OD Premium in ` 3449 TP Premium in ` 39036

Net Premium in `: 42138
GST in `: 7586
Total Payable in `: 49724

Signature Not
Verified
Digitally signed
by Srinivasan Policy No. : 45110331170100008490Document generated by 22794 at 01/11/2018 15:17:48 Hours.
Vaideswaran Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2018.11.01
For 15:17:49
redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
IST
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

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