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:0911014721P106316104
( 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 @ 27/09/2021 6:22:57 PM

This document is digitally signed

Signer: N MOHAN SANKAR

Date: Mon, Sep 27, 2021 18:24:01 IST
Location: United India Insurance Company Ltd
1/4 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. 0911014721P106316104

SCHEDULE

Policy No. 0911014721P106316104 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 : Four thousand six hundred seventy-five rupees only

Type of Cover: Named

DESCRIPTION OF ANIMALS INSURED

IDENTIFICATION Purpose Sum

Species/Breed Sex, Colour &
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 ,
PACKIRISAMY BROWN WITH DR
1 430079027338 Bovine/CBJ/Exotic 5 MILCH 25000
VAITHILINGAM WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
PACKIRIAMMAL BROWN WITH DR
2 430079027420 Bovine/CBJ/Exotic 5 MILCH 25000
GNANASANMUGAM WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
PACKIRIAMMAL BROWN WITH DR
3 430079027098 Bovine/CBJ/Exotic 5 MILCH 25000
GNANASANMUGAM WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
GUNASEKARAN BLACK WITH DR
4 430079126422 Bovine/HFX/Exotic 6 MILCH 25000
RAMALINGAM WHITE , BLACK MUTHUKUMARAN
WITH WHITE
Female ,
BLACK WITH DR
5 SELVI SIVASUPRAMANIAN 170252698820 Bovine/HFX/Exotic 6 MILCH 25000
WHITE , BLACK MUTHUKUMARAN
WITH WHITE
Female ,
BROWN WITH DR
6 SELVI SIVASUPRAMANIAN 430078924764 Bovine/CBJ/Exotic 6 MILCH 25000
WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
BROWN WITH DR
7 GOWRI JAYARAMAN 430079152433 Bovine/CBJ/Exotic 4 MILCH 25000
WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
BROWN WITH DR
8 MINNAL VANAN SELVARAJ 170252698658 Bovine/CBJ/Exotic 4 MILCH 25000
WHITE , BROWN MUTHUKUMARAN
WITH WHITE

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 WITH WHITE
Female ,
BROWN WITH DR
9 KUMAR CHINNAPILLAI 170252697952 Bovine/CBJ/Exotic 4 MILCH 25000
WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
MURUGANANTHAM BROWN WITH DR
10 170252698660 Bovine/HFX/Exotic 4 MILCH 25000
RAJAGOPAL WHITE , BROWN MUTHUKUMARAN
WITH WHITE
Female ,
BROWN WITH DR
11 UMA SARAVANAN 170266898506 Bovine/CBJ/Exotic 5 MILCH 25000
WHITE , BROWN MUTHUKUMARAN
WITH WHITE

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: 275000 Net Premium : 4,675.00
CGST(0%) : 0.00
SGST(0%) : 0.00
UTGST(0%) : 0.00
IGST(0%) : 0.00
Stamp Duty : 1.00
Total : 4,675.00
Receipt No. : 10109110121106763768
Receipt Date : 27/09/2021

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

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Office Copy

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

SAC Code: 997139 Invoice No. & Date: 4721I106316104 & 27/09/2021
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 )

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