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Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158P0005V01201718

YOUR DETAILS PARTNER DETAILS

Name: SAIDIREDDY GUJJULA Partner Name: POLICYBAZAAR INSURANCE BROKERS

PRIVATE LIMITED

Registration Number: AP29AR0004

N Partner Code : 1000158

Policy Number: D055003537 / 19012022

Partner Mobile Number: --
G0 Mobile Number: xxxxxxxxx4455

P Partner Email : crtmotor@policybazaar.com

M Email: sxxxxxxa@gxxxl.com

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YOUR POLICY DETAILS

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B Policy Issue Date 19-Jan-2022 Invoice No. IA057368086 Invoice Date 19-Jan-2022

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MA From 29-Jan-2022 00:00:01 NCB % (Current Policy) 35%

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Period of Policy for

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Own Damage Cover
To 28-Jan-2023 23:59:59 Additional Excess (`) --

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From 29-Jan-2022 00:00:01 Voluntary Deductible (`) 0.00

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Period of Policy for

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Third Party Liability
To 28-Jan-2023 23:59:59 Compulsory Deductible (`) 1000
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Period of Policy for
From -- --
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19 PA Owner-Driver
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W To -- --
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Add-Ons Opted -- Coverages Opted Package Policy

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Address 5-52/1A,STREET NO2, SHANTHI NAGAR COLONY,HYDERSHAKOTE,Hyderabad-500108

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YOUR VEHICLE DETAILS

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Model/Vehicle Variant (Sub-

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RTO Location Rangareddy,TELANGANA Make HYUNDAI i10/1.1 Magna

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IG Type)
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2177
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Seating Capacity 5 Fuel Type Liquid petrol gas Year of Regn./ 2012/2012
Manufacturing
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Engine No. B4HACM436289 Chassis No. ALAM51DLCM099541A Cubic Capacity 1086 CC

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FASTag Number. NA
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587.
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FASTag NUMBER DECLARATION

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58 The Policy has been issued subject to your affirmative declaration that a valid FASTag has been affixed on the insured vehicle.
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Call us at 1800-258-5956 to update your contact details. This will help us give you a smooth claim process.
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YOUR VEHICLE IDV

Year Vechicle IDV Non-Electrical Electrical CNG/LPG Trailer Total PA Owner

(`) Accessories IDV (`) Accessories IDV (`) IDV (`) IDV (`) IDV (`) Driver
Year 1 176752 -- -- -- -- 176752.00 --

Year 2 0 0 0 0 0 0 --
I340
Year 3 0 0 0 0 0 0 --

Policy No: D055003537

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Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158P0005V01201718
OWN DAMAGE PREMIUM [A] (`)
LIABILITY PREMIUM [B] (`)
Total Basic Own Damage Premium (`) 6219.00 Basic Third-Party Liability (`) 3221.00
NCB Discount Amount (`) -2177.00 PA cover for Owner-Driver (`) --
Others (`) -2950.55 Legal Liability to Employees (`) --
Own Damage Premium (`) 1091.45 Legal Liability to Paid Driver (`) --
Add-Ons Premium (`) 0.00 PA cover for 5 passengers 0 (`) --
CNG/LPG Premium (`) 60.00
PA cover for Paid Driver (`)
Total OD Premium (`) 1091.45 Total Act Premium (`) 3281.00
Net Premium (`) 4372.45 1091 3281
787.04 587.70
IGST @18%=(`787.04) 1091.45

Final Premium (`) 5159.49

Note: The above total OD premium is inclusive of all applicable loading / discounts viz (automobile association memberships, voluntary excess, anti-theft
handicap person, driver tuition, fiber glass, CNG/ LPG unit, geographical extension, imported vehicle etc., wherever applicable).
If the “Own Damage Cover” under your policy is cancelled during the policy period, then your policy shall be governed by the standard terms and conditions

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of “Act only” policy for the Third Party Cover during the remaining period of policy .

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ENDORSEMENT

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Invoice Number Invoice Date Gross Premium Igst Cgst Sgst Utgst Cess Net Premium

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IA057368086 2022-01-19 5159.49 787.04 0.00 0.00 0.00 0.00 4372.45

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OTHER DETAILS

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Previous Insurer ICICI Lombard General Insurance Co. Ltd.

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Previous Policy No. I3400831 Previous Policy Expiry Date 28-Jan-2022
IMT - Endorsements IMT-22
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GSTIN/UIN No. Unregistered State Code 36
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Payment Mode Online Cheque/Transation No PB45511129_154419896

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Bank Name IFSC/MICR No --

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Premium Payment Details Receipt Number RA058795839 Receipt Date 19-Jan-2022

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Financier Details -- Nominee Details --

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Other Details --
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Details of Existing Damages --

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Follow these rules like you follow the rules of the road.
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Geographical Area: Any accidental loss, damage and/or liability caused, sustained or incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and endorsed.. Limitation as
to use The policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial, speed testing and use for any purpose in connection with the Motor Trade. Person or Class of
persons entitled to drive: Any person including the insured 1) Provided that a person driving holds a valid & effective driving license at the time of the accident and is not disqualified from holding or obtaining such a
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license. 2) Provided also that the person holding a valid & 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 and
any subsequent amendment as applicable. Limits of Liability: 1) Under Section I of the policy _ IDV as shown in the schedule. 2) Under Section II - 1 (i)of the policy: Death of or bodily injury _ Such amount as is necessary to
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meet the requirements of the Motor Vehicles Act, 1988. 3) Under Section II _ 1 (ii)of the policy: Damage to Third Party Property _ ` 4) P.A. Cover for Owner Driver under Section III (CSI) - `
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NCB Declaration: The premium has been charged and policy has been issued subject to NCB declared by you as an insured. In the event of NCB found wrongly declared at any point of time during policy period, all
benefits and coverages under the Policy in respect of section I of the Policy will stand forfeited. If there is any disagreement, write to us within 7 days from the date of issuance of policy or before the start date of period of
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insurance whichever is earlier.PUC Declaration: The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of commencement of the Policy .
Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in case of dishonor of Cheque or non-receipt of payment. Violation of Motor Vehicle Act: This policy is issued in
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accordance with the provision of Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 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 Certificate in order to comply with the Motor Vehicle
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Act, 1988 is recoverable from the insured. See the Clause headed (Avoidance Of Certain Terms And Right Of Recovery) in the policy. Pre-existing Damages: All types of pre-existing damages or cost of repair of such
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damage will be excluded at the time of claim settlement,as per the attached images. Important Notice: The company may cancel the policy by sending 7 days notice in case of fraud, misrepresentation, non disclosure of
material fact or non co-operation of the insured. This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff. Break in Insurance: The policy
is issued subject to acceptance of risk after evaluation of the Vehicle Inspection report. Own Damage cover (Section - I) would not commence unless the satisfactory Vehicle Inspection report has been received by us. If the
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Company does not receive the Vehicle Inspection report or the report is adverse, the Company, at its discretion, will cancel Policy as per the Motor Tariff. Important Note:Please inform the Company in case of change on
account of addition of CNG/PNG kit.
Note: The terms and conditions detailed in this policy schedule as well as the policy document sent by Digit shall prevail in case of any dispute.
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The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of your declaration that you do not hold a valid Driving License on or before the date of commencement of this
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Policy / already have an alternate Personal Accident insurance cover of Rs. 15 Lakhs
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Policy No: D055003537

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PB
Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158P0005V01201718
For & On Behalf of Go Digit General Insurance Ltd.

In case of claim or any other query, please

contact our 24-hour Call Centre at
1800-258-5956 or email us at
hello@godigit.com or visit our Praveen Bhat
website www.godigit.com. Senior Vice President - Customer Experience
praveen.bhat@godigit.com
Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty has been paid as per
Letter of Authorization No.67-B/04/2017-18 Date:
30th May 2017 issued by Department of Stamps
and Registration , Bengaluru- 560009 -
KARNATAKA.
Hey, our document is now digitally signed
Click here to view the certificate.
For instant resolution, you can ping us “Hi” on
WhatsApp at 702 606 1234

Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. IRDAI Reg No. 158 CIN U66010PN2016PLC167410, GST Reg. No.:
29AACCO4128Q1ZW HSN: 997134/General Insurance Services, GSTIN Address:Bangalore Broker Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-
560095

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This is the end of the document and the beginning of a wonderful relationship.

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We hope that you do not get in a situation when you have to file a claim. However, if that happens, we are always there
for you. That’s a promise!

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Stay Calm and just relax! We will take care of everything!
You can take your car to any of the listed network garages in case anything happens, and we assure you a hassle-free

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claim process.

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• Complete cashless facility • 6 Months warranty on repairs • Complimentary Pick-up & Drop
*Facilities mentioned above are offered by the garages. List of garages is subject to change in future. Please 28
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call on 1800-258-5956 in case you require further help.
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Policy No: D055003537

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