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Two Wheeler Package Policy

Product Code: 3005 UIN:IRDAN115P0015V02200708

CERTIFICATE CUM POLICY SCHEDULE

For all your insurance needs & query call us at our Toll free No.: 1800-2666(Accessible from your mobile also), you can also E-mail us at:
customersupport@icicilombard.com
Certificate cum Policy No : 3005/2011512824/B0/0000000100
Name of the Servicing IL Ahmedabad
Branch
Address of IL Branch Third Zodiac Square S G road Ahmedabad Gujarat 380054
RTO Location GUJARAT-SURAT
Period of Insurance From 00:00 18/09/2019 To 17/09/2020 midnight
Intermediary Code 202103104172
Insured Name RAMANBHAI BHAGUBHAI AHIR Policy Issued On 17/09/2019
14, AHIR WAS KANSAD, SACHIN , SURAT, GUJARAT, Pin -
Insured Address Hypothecated With
394230
Invoice No 1709192633733 Category
91-9737784518(Mobile
Primary Vertical Name BANCASSURANCE-Motor Two Wheeler (M6) Contact No.
No.)
Registration Mfg Seat
Make Model Type of body CC Chassis Number Engine Number
Number Year Cap
HONDA ME4KC09CKE8825622
GJ05LQ4518 CB UNICORN Solo With Pillion 150 2014 2 KC09E86835952
MOTORCYCLE
Additional NonElectrical Electrical/Electronic
Vehicle IDV Side Car CNG/LPG Unit Total Value
Acc Acc Acc
27744 0 0 0 0 0 27744
SCHEDULE OF PREMIUM
Own Damage(A) Liability(B)
Basic Own Damage 513.78 Basic Third Party Liability 752.00
Total 514.00 PA Cover For Owner-Driver Of Rs. 1500000 375.00
Total 1127.00
Total Own Damage Premium 514.00 Total Liability Premium 1127.00
Total Package Premium (A+B) 1641.00
Net Premium 1641.00
CGST@9% 147.69
SGST@9% 147.69
Kerla Flood Cess @1% 0.00
Total Tax Payable 295.38
Total Premium 1936.00
For No claim Bonus (NCB), Coverages and exclusion of policy Please refer to the policy wordings attached with this schedule, in case of you have not received your
kindly write to us at the below mentioned mailing address.
Compulsory Deductibles : Rs.100 GeographicalArea India *** All Premium figures are in Rupees
Limits Of Liability : (a)Under Section II-1 (i) of the policy->Death of or bodily injury: Such amount as is necessary to meet there requirements of the Motor Vehicles
Act,1988.(b)Under Section II-1 (ii)of the policy-> Damage to Third Party Property Rs 100000.00; PA Cover for Owner-Driver under section III: CSI Rs 1500000.00. *
as opted for the above-mentioned period *
LIMITATIONS AS TO USE: The policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal
luggage), Organized racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.
DRIVER'S CLAUSES: Any person including the insured : Provided that a person driving holds an 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 Central Motor Vehicles Rules, 1989.
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 RIGHT OF RECOVERY". For legal interpretation,English version will hold good
Subject to IMT Endorsement Nos. & Memorandum printed herein / attached hereto : 22,28
Premium Collection Details :
I/We hereby certify that the policy to which the certificate relates as well as, this certificate of insurance are issued in accordance with the provision of Chapter XI of
Motor Vehicle Act, 1988.

Agency Code: AFDPC4079H45630 Agency Name: BABA AUTOMOBILES

Agent's Mobile No.: 91-9983293424 Agent's Landline No.:
Disclaimer: Please visit www.icicilombard.com for the policy wordings, for complete details on terms and conditions governing the coverage and NCB. This document is
to be read with the policy wordings. The policy is valid subject to realization of cheque. We accept premium only via legally recognized modes. In case of dishonor of
premium cheque, The company shall not be liable under the policy and the policy shall be void ab-initio. In case of any discrepancy with respect to the policy, please
revert within 15 days from the policy start date. This policy is underwritten on the basis of the information provided by you and as detailed in the Risk Assumption
Letter shared with you along with the policy. On renewal, the benefits provided under the policy and/or terms and conditions of the policy including premium rate may
be subject to change.
Grievance Clause:
For resolution of any query or grievance you may contact us on our toll free no.1800-2666, or visit any of our branch offices. You can also write to us at
customersupport@icicilombard.com. For detailed grievance redressal mechanism please visit the “Grievance Redressal” section on our website www.icicilombard.com.

The stamp duty of Re. 0.5 paid vide deface no. CSD1052019379319 dated Aug For ICICI Lombard General Insurance Company Ltd
05, 2019
GSTIN Registration No. : 24AAACI7904G1ZT
HSN/SAC Code: 9971
SAC DESC: General Insurance Services Duly Constituted Attorney(s)
IRDA Registration no. 115 COPY OF POLICY

Warranted that the insured named herein/owner of the vehicle holds a Valid Pollution Under Control(PUC) Certificate and/or valid fitness certificate,as applicable,on the
date of commencement of the Policy and undertakes to renew and maintain a valid and effective PUC and/or fitness certificate,as applicable ,during the subsistence of
the policy.Further ,the Company reserves the right to take appropriate action in case of any discrepancy in the PUC or fitness certificate.
ICICI Lombard General Insurance Company Ltd

file:///C:/Program%20Files%20(x86)/ILPOS%20Motor%20Insurance/PolicySchedule... 01/10/2020