Office Copy

UNITED INDIA INSURANCE COMPANY LIMITED

19, SUDHA COMPLEX NEELA SOUTH STREET, NAGAPATTINAM, NAGAPATTINAM, TAMIL NADU
NAGAPATTINAM - 611001 TAMIL NADU
PH: (04365) 241569 FAX: EMAIL:

MICRO-INSURANCE PRODUCT-CATTLE INSURANCE POLICY

POLICY NO:0911014721P106326898
( DUPLICATE )

PERIOD OF INSURANCE
From 00:00 Hrs of 08/09/2021
To Midnight of 07/09/2022

Insured
MS TAMILNADU LIVESTOCK DEVELOPMENT AGENCY CHENNAI (NATIONAL
LIVESTOCK MISSION)
ADAH, NEARBY NEW BUS STANTD NAGAPATTINAM
611001
NAGAPATTINAM
TAMIL NADU
IMPORTANT NOTICE: KINDLY UPDATE YOUR AADHAAR NO. AND PAN/FORM 60. PLEASE IGNORE IF ALREADY UPDATED.

Agent Name :
Agent Code :
Mobile/Landline Number/Email :

The genuineness of the policy can be verified through "Verify Your Policy" link at www.uiic.co.in.

For any Information, Service Requests, Claim intimation and Grievances please write to 091101@uiic.co.in

Download Customer App(www.uiic.co.in). REGD. & HEAD OFFICE, 24, WHITES ROAD, CHENNAI - 600014.
Website: http://www.uiic.co.in
Printed By : AMA45428 @ 28/09/2021 11:04:22 AM

This document is digitally signed

Signer: N MOHAN SANKAR

Date: Tue, Sep 28, 2021 11:05:40 IST
Location: United India Insurance Company Ltd
1/7 Reason: Signing Policy for UIIC
Office Copy

MICRO-INSURANCE PRODUCT-CATTLE INSURANCE POLICY

WHEREAS the Insured named in the Schedule hereto has made to United India Insurance Company Limited(herein after called the
"Company", a proposal and declaration which shall be the basis of this contract and be deemed to be incorporated herein for the
Insurance hereinafter contained and has paid the premium stated herein.

THE COMPANY hereby agrees subject to the terms, provisions, conditions, contained herein or endorsed to otherwise expressed thereon
that if any animal described in the Schedule and belonging to the Insured shall die from any disease or accident (including fire and
lightning) contracted or occurring during the period of Insurance stated herein or any subsequent period in respect of which the insured
shall have paid and the Company shall have accepted the premium required for the renewal or extension thereof the Company will pay to
the Insured after receipt of proof of death satisfactory to the Company the loss which the Insured shall suffer by the death of such animal
not exceeding the Sum Insured in respect thereof as stated in the Schedule hereto or its Market value at the time of loss whichever is
less. However, the company's liability is restricted to 50% of Sum Insured or market value whichever is less if the animal prior to death
giving rise to a valid claim under the Policy is not pregnant or four months less of pregnancy or not in milk production.

Policy No. 0911014721P106326898

SCHEDULE

Policy No. 0911014721P106326898 Previous Policy No.

MS TAMILNADU LIVESTOCK DEVELOPMENT AGENCY
Name/ID CHENNAI (NATIONAL LIVESTOCK
MISSION)/ 23085793683
Insured Details
Tel (O): Tel (R) Fax:
Email Mobile:
Business / Occupation None Date of Declaration
Period of Insurance From 00:00 Hrs of 08/09/2021 To Midnight of 07/09/2022

Coinsurance UIIC 091101 : 100%

PREMIUM : Forty-seven thousand two hundred sixty rupees only

Type of Cover: Named

DESCRIPTION OF ANIMALS INSURED

IDENTIFICATION Purpose
Species/Breed Sex, Colour & Sum
Sl. Name of the Animal's for Veterinarian Insured(
Indigenous/Cross Distinguishing AgeHeight
No. Owner/Borrower/Loanee Number(Ear which Name
breed/Exotic Marks )
Tag/Marks) Used
Female ,
MANGAYARKARASI
1 170251416501 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
SIVAKMAR
Brown,White
Female ,
MANGAYARKARASI
2 170251416784 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
SIVAKMAR
Brown,White
Female ,
Black,White ,Brown
3 BOOPATHY SELLAPPA 170251804887 BOVINE/CBJ/Indigenous 4 MILCH DR.C.LAWRENCE 30000
, Black,White
,Brown
Female ,
4 TAJNISHA ABDULKADAR 430079156711 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
5 KAJA AYYAKANNU 170251804524 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
Black,White,Brown
6 KAJA AYYAKANNU 430079194530 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
,
Black,White,Brown
Female ,
SILAMBARASAN
7 170251804717 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
UTHRAPATHY
Brown,White
Female ,
SILAMBARASAN Black,White,Brown
8 170251804400 BOVINE/CBJ/Indigenous 4 MILCH DR.C.LAWRENCE 30000
UTHRAPATHY ,
Black,White,Brown
Female ,
SILAMBARASAN
9 170251804386 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
UTHRAPATHY
Brown,White
Female ,

2/7
 VAITHYANATHAN Brown,Black,White
10 170251802493 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
AYYAKANNU ,
Brown,Black,White
Female ,
VAITHYANATHAN Brown,Black,White
11 170251802618 BOVINE/CBJ/Indigenous 4 MILCH DR.C.LAWRENCE 30000
AYYAKANNU ,
Brown,Black,White
Female ,
Black,White,Brown
12 SOUNDARAJAN NAGAPPAN 430079199081 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
,
Black,White,Brown
Female ,
13 SOUNDARAJAN NAGAPPAN 430079194825 BOVINE/CBJ/Indigenous Gray,white , 5 MILCH DR.C.LAWRENCE 30000
Gray,white
Female ,
14 SOUNDARAJAN NAGAPPAN 430079156037 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
15 JAYAVEL SUBBAIYA 430079156697 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
Black,White,Brown
16 KUMAR ANNAMALAI 430079156700 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
,
Black,White,Brown
Female ,
17 KUMAR ANNAMALAI 430079156607 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
KALLIDOSS
18 430078835004 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
SUBRAMANIYAN
Brown,White
Female ,
19 DURAIRAJ KUPPSAMY 430078805160 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
20 DURAIRAJ KUPPSAMY 170251805607 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
21 JAYANTHI VASUDEVAN 430078816577 BOVINE/CBJ/Indigenous Black,White , 5 MILCH DR.C.LAWRENCE 30000
Black,White
Female ,
22 ANUSHIYA KANNAN 170251287903 BOVINE/CBJ/Indigenous Black,White , 5 MILCH DR.C.LAWRENCE 30000
Black,White
Female ,
23 KAMALAMBAL SAKTHIVEL 170251288746 BOVINE/CBJ/Indigenous Black,Brown , 5 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
24 JEEVARAMAN VADIVEL 170251287856 BOVINE/CBJ/Indigenous Gray,white , 5 MILCH DR.C.LAWRENCE 30000
Gray,white
Female ,
PRASANTH
25 170251288564 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
THANGAPRAGASAM
Brown,White
Female ,
26 JAYA SOUNDARAJAN 170251288096 BOVINE/CBJ/Indigenous Black,Brown , 5 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
27 AKILA SEKAR 170251284721 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
PARAMESHWARAN
28 170251287960 BOVINE/CBJ/Indigenous Gray,white , 4 MILCH DR.C.LAWRENCE 30000
THANGARAU
Gray,white
Female ,
29 SUBRAMANIYAN NATESAN 170251288187 BOVINE/CBJ/Indigenous Black,Brown , 3 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
30 KANNAN SUBRAMANIYAN 170251288804 BOVINE/CBJ/Indigenous Black,Brown , 5 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
31 KALAISEVAN SELVARASU 430078816032 BOVINE/CBJ/Indigenous Gray,white , 5 MILCH DR.C.LAWRENCE 30000
Gray,white
Female ,
32 ARUMGAM DARMAN 170251287025 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
33 DURAIRAJ KATHAMUTHU 430078816896 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
SUBRAMANIYAN
34 170251290642 BOVINE/CBJ/Indigenous Black,Brown , 3 MILCH DR.C.LAWRENCE 30000
KATHAMUTHU
Black,Brown
Female ,
GURUNAMSINGH
35 170251292171 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
GANESAN
Brown,White
Female ,
36 VEMBU GOVINDARAJ 100042948342 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
37 VIJAYALKSHMI BASKARAN 100042943961 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White

3/7
 Female ,
38 JAYANTHI SANKARAN 100043134005 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
39 KASTURI KUMAR 100042949265 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
40 MALATHI ANBAZHAGAN 100042948422 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
41 GAYATHIRI SATHISH 170251806703 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
BUVANESHWARI
42 100043134131 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
SIVAPRAKASAM
Brown,Black
Female ,
43 UMABATHRI SIVAKUMAR 100042949312 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
44 KALAISELVI VEERAMANI 100042947612 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
45 VIJAYA GUNASEKARAN 100042949287 BOVINE/CBJ/Indigenous Black,Brown , 4 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
46 REVATHI RAMAN 430079194450 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
GANGASUNTHARI
47 100042947714 BOVINE/CBJ/Indigenous Brown,White , 4 MILCH DR.C.LAWRENCE 30000
RAMESH
Brown,White
Female ,
48 EZHILARASI MATHIVANAN 100042948240 BOVINE/CBJ/Indigenous Black,Brown , 5 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
49 REVATHI KMAR 100043132943 BOVINE/CBJ/Indigenous Black,Brown , 5 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
KAVICHANDRAN
50 430079200645 BOVINE/CBJ/Indigenous Brown,White , 3 MILCH DR.C.LAWRENCE 30000
RAMACHANDRAN
Brown,White
Female ,
51 FATHIMA MOHANDOSS 430103540041 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
52 VEERAMANI RAMASAMY 170251286955 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
53 KALA JAYARAMAN 430078715727 BOVINE/CBJ/Indigenous Brown,White,Gray , 5 MILCH DR.C.LAWRENCE 30000
Brown,White,Gray
Female ,
GUNASEKARAN Brown,Black,White
54 430078783675 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
MANIMARAN ,
Brown,Black,White
Female ,
Brown,Black,White
55 REVATHI MURUGADOSS 170251287572 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
,
Brown,Black,White
Female ,
RAGUPATHY
56 170251287242 BOVINE/CBJ/Indigenous Brown,Black , 4 MILCH DR.C.LAWRENCE 30000
VENGATRAMAN
Brown,Black
Female ,
TAMILARASI
57 430079191596 BOVINE/CBJ/Indigenous Brown,White , 3 MILCH DR.C.LAWRENCE 30000
ADIYAPATHAM
Brown,White
Female ,
TAMILARASI Brown,Black,White
58 430079191756 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
ADIYAPATHAM ,
Brown,Black,White
Female ,
59 BOOSCO GANAGARAJAM 170251287151 BOVINE/HFX/Indigenous Black,White , 4 MILCH DR.C.LAWRENCE 30000
Black,White
Female ,
VETRISALVAN
60 170251287710 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
PAKIRISAMY
Brown,White
Female ,
ANBAZHAGAN
61 430078816134 BOVINE/CBJ/Indigenous Brown,Black , 4 MILCH DR.C.LAWRENCE 30000
MURUGAIYAN
Brown,Black
Female ,
62 SARASWATHI RAJASEKAR 430078715740 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
63 RAJAPPA PAKIRISAMY 170251287231 BOVINE/CBJ/Indigenous Brown,White , 3 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
64 SEKAR DANAPAL 170251769885 BOVINE/CBJ/Indigenous Brown,Black , 3 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
65 SEKAR DANAPAL 170251769896 BOVINE/CBJ/Indigenous Brown,Black , 4 MILCH DR.C.LAWRENCE 30000
Brown,Black

4/7
 Female ,
66 SANTHI SEKAR 430078816156 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
67 INDIRA SELAVARAJ 170251287845 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
68 SELVAKUMAR VEERASAMY 430078816475 BOVINE/CBJ/Indigenous Dark Brown , Dark 9 MILCH DR.C.LAWRENCE 30000
Brown
Female ,
69 SUDHA VELMURUGAN 170251287457 BOVINE/HFX/Indigenous White,Black , 2 MILCH DR.C.LAWRENCE 20000
White,Black
Female ,
70 SUDHA VELMURUGAN 430078723111 BOVINE/CBJ/Indigenous Brown,Black , 5 MILCH DR.C.LAWRENCE 30000
Brown,Black
Female ,
71 INDIRA SELAVARAJ 430078815951 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
72 AMSAVALLI VAIRAKANNU 430078816178 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
73 SEKAR DANAPAL 430078830097 BOVINE/CBJ/Indigenous Brown,White , 5 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
VALARMATHI
74 170251287093 BOVINE/CBJ/Indigenous Brown,White,Gray , 5 MILCH DR.C.LAWRENCE 30000
ANBAZHAGAN
Brown,White,Gray
Female ,
RANGANAYAGI
75 430078816225 BOVINE/HFX/Indigenous Black,White , 5 MILCH DR.C.LAWRENCE 30000
SONDARRAJAN
Black,White
Female ,
76 JAYABAL MASAAK 170251287140 BOVINE/ND/Indigenous Gray,white , 5 MILCH DR.C.LAWRENCE 30000
Gray,white
Female ,
77 SEKAR SINGARANI 430078816418 BOVINE/CBJ/Indigenous Gray,white , 5 MILCH DR.C.LAWRENCE 30000
Gray,white
Female ,
78 PAKIRISAMY THAIYAN 170251281468 BOVINE/ND/Indigenous 5 MILCH DR.C.LAWRENCE 30000
Gray , Gray
Female ,
79 PAKIRISAMY THAIYAN 430078715911 BOVINE/ND/Indigenous 6 MILCH DR.C.LAWRENCE 30000
Brown , Brown
Female ,
80 VANILAVU VADIVEL 170251281526 BOVINE/CBJ/Indigenous Brown,White , 6 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
81 SANTHI SUBRAMANIYAN 170251281765 BOVINE/CBJ/Indigenous Brown,White , 6 MILCH DR.C.LAWRENCE 30000
Brown,White
Female ,
SUMATHI
82 170251287060 BOVINE/CBJ/Indigenous Brown,White , 6 MILCH DR.C.LAWRENCE 30000
RAMACHANDRAN
Brown,White
Female ,
83 JAYARAMAN MARIYAPPAN 430103781692 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
Brown , Brown
Female ,
84 SANKAR PAKIRISAMY 170251287047 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
Gray , Gray
Female ,
85 BANU PANEERSELVAM 170251287457 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
Brown , Brown
Female ,
86 INDIRANI SRINIVASAN 430078816453 BOVINE/CBJ/Indigenous 6 MILCH DR.C.LAWRENCE 30000
Brown , Brown
Female ,
87 VASUKI RAVI 170251287515 BOVINE/CBJ/Indigenous 7 MILCH DR.C.LAWRENCE 30000
Gray , Gray
Female ,
88 VIMALA MURUGESAN 430078816613 BOVINE/CBJ/Indigenous 7 MILCH DR.C.LAWRENCE 30000
Brown , Brown
Female ,
89 SELVAKUMAR VEERASAMY 170266203778 BOVINE/CBJ/Indigenous 8 MILCH DR.C.LAWRENCE 30000
Brown , Brown
RENGASAMY Female ,
90 170251286897 BOVINE/CBJ/Indigenous 5 MILCH DR.C.LAWRENCE 30000
VAITHIYANATHAN Brown , Brown
Female ,
91 DHAMAYANTHI KUMAR 170251418597 BOVINE/CBJ/Indigenous Black,Brown , 7 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
92 DHAMAYANTHI KUMAR 170251417936 BOVINE/CBJ/Indigenous Black,Brown , 6 MILCH DR.C.LAWRENCE 30000
Black,Brown
Female ,
93 SUDHA VELMURUGAN 450000032750 BOVINE/HFX/Indigenous White,Black , 5 MILCH DR.C.LAWRENCE 30000
White,Black

Tag should be surrendered at the time of claim,otherwise it will be treated as No claim.

In the event of death of animal/s covered under the policy, claim/s shall not be entertained unless the ear tag/s are surrendered to the
Company. In the event of loss of ear tag/s, it is the responsibility of the insured to give immediate notice to the Company and get the
animal retagged.
The Company is not liable to pay the claim in the event of death of insured animal due to disease occurring within 15 days from the
commencement of risk.
Total Sum Insured: 2780000 Net Premium : 47,260.00
CGST(0%) : 0.00
SGST(0%) : 0.00

5/7
 UTGST(0%) : 0.00
IGST(0%) : 0.00
Stamp Duty : 1.00
Total : 47,260.00
Receipt No. : 10109110121106774283
Receipt Date : 28/09/2021

Agency/Broker Code:
Dev.Officer Code:

Location of the farm or place where the animals are stabled: FOH
Special Conditions /exclusions: ,NO TAG NO CLAIM

6/7
Office Copy

Customer GST/UIN No.: Office GST No.: 33AAACU5552C1ZQ

SAC Code: 997139 Invoice No. & Date: 4721I106326898 & 28/09/2021
Amount Subject to Reverse Charges-NIL

Anti Money Laundering Clause:-In the event of a claim under the policy exceeding 1 lakh or a claim for refund of premium exceeding
1 lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company's web site.

LET US JOIN THE FIGHT AGAINST CORRUPTION. PLEASE TAKE THE PLEDGE AT https://pledge.cvc.nic.in.

Date of Proposal and Declaration: 08/09/2021

IN WITNESS WHEREOF,the undersigned being duly authorised has hereunto set his/her hand at BO NAGAPATTINAM 091101 on this 27th
day of September 2021 .

For and On behalf of CONSOLIDATED

United India Insurance Co. Ltd. STAMP DUTY PAID AS
PER TAMIL NADU
GOVERNMENT G.O.
(RT.) No.222 DATED
10.07.2020 FOR THE
PERIOD FROM
01.04.2021 TO
Duly Constituted Attorney(s)
30.09.2021
Underwritten By - AMA45428 ( BO UW CUM CASHIER )

7/7