IFFCO - TOKIO GENERAL INSURANCE CO.

LTD
Regd. Office: IFFCO SADAN,C1 Distt Centre,Saket,New Delhi- 110017 Servicing Office :
IFFCO TOKIO GENERAL INSURANCE CO LTD
Endorsement Two Wheeler Package Policy
SCO-28,Second Floor, Sector-14
Cum Tax Invoice
ORIGINAL FOR RECIPIENT Gurgaon-122001
GST PNo:0124-4108790-93&Fax No:0124-4108794

- POS State Code: 06 , GSTIN: 06AAACI7573H1ZG

C / N No : General Insurance Services:- 9971

Insured's SHUBHAM KANOJIA : 1-154UY0GT
Original Invoice No.
Address :
18 SHANTI NAGAR , AMBALA CANTT Unique Invoice No. : 1-154UY0GT00002
, Policy No. : M8414412
PANJOKHARA (29) HARYANA PinCode 133001
Date of Issuance : 18/06/2019
State Code: 06 Country Name India GSTIN/UIN Endorsement From 1119 :
Effective 20/06/2019
To Mid Night : 19/06/2020
Phone Number 9991932325 POS Aadhar No 422528072671 Agent No 2500080625A
Geographical

Insured Motor Vehicle Details & Premium Calculation

Registration Year of Type of Body Engine No.
CC Coverage IDV in (`) Seating
Mark & No Manuf. - Capacit
003295
Make of Vehicle Chassis No.
HR856833 2017 HONDA CB HORNET 160R STD 163 Comprehensive 63800 2
002211
Registration Authority
Insured Declared Values (`)
Vehicle Trailer Non Electrical Acc. Electrical Acc. Bi-Fuel Kit Total Value Service Tax
63800 0 0 63800 0.00

Notwithstanding anything contained herein to the contrary it

is hereby declared, understood and agreed that the Vehicle's

Registration Number should be read as given below and not as

mentioned in the policy with effect from 20.06.2019

REGISTRATION NO : HR856833

Subject otherwise to all other terms, conditions, exceptions

and limitations of this Policy remains unaltered

Taxable Value Service Tax Swachh Bharat Cess Transfer Krishi Kalyan Cess Total Premium
0.00 0.00 0.00 0.00 0 0.00 0.00
CGST SGST/UTGST IGST CESS

Percentage 0.00 0.00 0.00

Amount 0.00 0.00 0.00

Under Hire Purchase/Hypo/ Lease

Subject to IMT Endorsement 28 Printed herein / attached
The Endorsement wordings are attached (as per IMT), Please go through your Endorsement and in case of any discrepency,
I/we hereby certify that the Policy to which this Certificate relates as well as this Certificate of For IFFCO-TOKIO General Insurance Co.
Insurance are issued in accordance with the provisions of Chapter X and Chapter XI of M.V.Act
.1988.

Toll Free : 1-800-103-5499 ; Other : ( 0124) 428-5499 ; SMS "claim" to 56161 Name of Signatory:- Subrata
Service Tax No : AAACI7573HST001 Corporate Identity No (CIN) U74899DL2000PLC107621 Mondal
Policy Issuing Office: Delhi Consolidated Stamp Duty deposited as per the order of Government of National Designation:-Executive Vise
Capital Territory of Delhi President