THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Commercial Vehicle Package Policy

UIN Number - IRDAN190RP0044V01100001

Insured's Details Policy Details

Insured's Name: SHARDA MOTORS Policy number: 33200031200100003337
Customer ID: PO78914464 (PAN No :NA) Period of cover: 03/08/2020 12:00:01 AM to 02/08/2021
11:59:59 PM
Insureds Address: C/O PROP. AMIT KUMAR MAHESHWARI,R/O Registration no. RJ-09-GC-2639
NEAR SUBASH CHOWK STATAION ROAD
NIMBAHERA,,
CHITTORGARH ,RAJASTHAN, 312001
Prev. Policy no. 2908013119P105583864 Make/Model: TATA MOTOR/SIGNA 4923
Email: amit1sharda@yahoo.co.in Receipt no. 33200081200000003824 - 31/07/20
Phone Number : / / 9414109788 Fax Number : NA / NA

GSTIN/UIN 08AHRPM9364M1ZA / NA
Issuing office New India Contact
Address CHITTORGARH DIVISIONAL OFFICE (332000), Agent / Corp. Agent /
MEERA HALL MEERA MARKET CHITTORGARH (RAJ.) , Broker / Banc Mrs. Radha Sahu -
CHITTORGARH , , Assurance / Referral
RAJASTHAN , 312001. Code - Name / (NIAAG00090044)
POS/IMF/SPECIFIED
PERSON
Phone no / / 7619701740
Phone no 1472241192 Fax no. /
Fax no. NA / NA Email radhasahu0505@gmail.com /
Email nia.332000@newindia.co.in Development officer RAMESHWAR LAL JAT - (1D4907147)
level Name/Code
Claim Contact CHITTORGARH DIVISIONAL OFFICE (332000) Claim Contact Detail MEERA HALL MEERA MARKET CHITTORGARH
(RAJ.),CHITTORGARH,;1472241192//
GSTIN 08AAACN4165C2ZQ
SAC 997139 (Other non-life insurance services excl RI)
Policy Details
Geographical Area / Zone: India/C Year of manufacture: 2018
Type of Commercial Vehicles: A - Goods Carrying Sub Type: Other than 3 wheeler - Public Carrier
Name of the Financier: TATA MOTORS FINANCE LTD Chassis no./Engine no.: MAT704108JAF15032/81D84477367
Type of fuel: Diesel Cubic capacity ( cc): 0
Type of body: Tanker Gross Vehicle Weight (GVW): 55000
Seating capacity including Driver: 6 Variant: CAB 3800MM
Automobile Association Colour: white
membership:
Cover Note No/Cover Note Issue / Name of registration authority: Chittogarh
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
3000000 0 0 0 0 3000000
Schedule of Premium
Own Damage Liability
Basic OD Cover Basic TP Cover
GVW above 12000KG, Towing Coverage, Inclusion of IMT LL to persons employed for opn and/or
23 maint.and/or loading and/or unloading, LL
to paid driver conductor cleaner employed
for oprn
NCB(25%)
OD Premium in ` 9327 TP Premium in ` 41861
Net Premium in `: 51188
GST in `: 6720
Total Payable in `: 57908
Total Payable in `(in words): RUPEES FIFTY-
SEVEN THOUSAND
NINE HUNDRED
EIGHT ONLY

Signature Not
Verified
Policy No. : 33200031200100003337Document generated by AG_0098693 at 31/07/2020 14:16:29 Hours.
Digitally signed
by Srinivasan Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Vaideswaran Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
Date: 2020.07.31
For 14:16:31
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.

Page 1 of 3
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Limitations as to use Limits of Liability

The Policy covers use only under a permit within the meaning of the Limit of the amount the Company's Liability Under Section II 1(i) in
Motor Vehicles Act, 1988 or such a carriage falling under Sub-section 3 respect of any one accident: as per the Motor Vehicles Act, 1988. Limit
of Section 66 of the Motor Vehicles Act, 1988.The Policy does not of the amount of the Company's Liability Under Section II 1(ii) in
cover use FOR a)Organised racing b) Pace Making c)Reliability Trials d) respect of any one claim or series of claims arising out of one event:
Speed Testing Up to ` 7,50,000
For individual covers (OD) in `: 3000000
Imposed excess in `: 0
Voluntary excess in `: 0
Compulsory excess in `: 1500
Persons or classes of persons entitled to drive
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 requirement of Rule 3 of the Central Motor Vehicles Rules, 1989.
PA cover for Owner Driver

Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
none 0 none none none

PA cover for named persons

Name CSI Opted(`) Nominee Relationship
NA NA NA NA

Premium and GST Details

Rate of Tax Amount in INR

Premium `9627
SGST 9 866
CGST 9 866
IGST 0 0

Premium `41561
SGST 6 2494
CGST 6 2494
IGST 0 0

In witness where of this policy has been signed at CHITTORGARH DIVISIONAL OFFICE on this 31/07/2020
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to Package/Liability policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,23,40,7.
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 Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case  the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.

I/We hereby certify that the policy to which this Certificate relates as For and on behalf of The New India Assurance Company Limited.
well as this Certificate of Insurance are issued in accordance with
the provisions of Chapter X and XI of M.V. Act, 1988. NIA S.T.REGN
No: AAACN4165CST181.
Date of Issue: 31/07/2020

Policy No. : 33200031200100003337Document generated by AG_0098693 at 31/07/2020 14:16:29 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For 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
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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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

( SATYA PRAKASH PUROHIT)

[DIVISIONAL MANAGER]

Duly Constituted Attorney(s)

Tax Invoice No : 33200020P0004294

IRDA Registration Number: 190

Policy No. : 33200031200100003337Document generated by AG_0098693 at 31/07/2020 14:16:29 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For 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
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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