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IRDAI Registration Number - 137 CCIN No. 66010R}2006PL.C029979 " Bi — SHRIRAM GENERAL INSURANCE COMPANY LIMITED SHRIRAM 6, EPP, RICO Inder! Ares, Skapor, spur Rajesthon 202022, |NOIA Daniral (neurandd Email :chd@stramgicom,Webstewarishiramgl.com ricoeen eneerseetnes sovated win @) Sanam sro CERTIFICATE CUM POLICY SCHEDULE (POS - PCV. wheelrs-carning pasanger-capacy NOT>6-Zone 8 ‘MOTOR COMMERCIAL VENIGLE AGRAGE POLICY) ‘Un NoROANTTRPOGTOVO%z00608 SAC Code: 957? iaaeae {08050-Aacress kof, Ta Fone oF St Nery. lResua Office Phone Wo. 7 O5442-220257, 250750 2 [Convent Scot, MIRZAPGR, UTTAR PRADESH) 3S e 251003 2 [ccoqaphicalares [TWO Palio. [108050731723 /000855 Ansured’s code/ Name _|tN-25084129 7 WR- RAN PYARE BIND —|egvin Ne Of nsurca—lUmenoroae insured address INAROIYA (AGANPUR) SYGHA 1 B. [SIENA RS g |, MIRZAPUR, UTTAR PRADESH z 1231918 - Insured state code [> [Nee Discount 26) o R executive ABRISHEX SRIVASTAVA = NARDODOOIDST — |period of tasurance | Pow 1648 Wa of 27 /O6/SURE To 2 | Midnight of 26/06/2023 8 [Avent betas |APOORVA MODANWAL ~ PSNGDOOTZO5- 3 Mobile No.7007Laea1e 8 panne. [aczPuS7OF 3 NA WA [Ra 8 5677 [0 = sit, siT 5 [Previous insurer RA : ca [Previous Policy Wa JWA Re RAL OMAR BIND [Nominee age ie no so [Appointee Name zy A REGISTRATION [ENGINE NO. & CHASSISNG, | HARE= ODE] ee SE Sosy ‘PRETTY DATE OF [SEAT CAP MARK & PLACE lructvee “ |veaRormanr. |reany — |cncw a lbeuiveny few bsimezososes @ ['5 AUTO 8A STAWERTCKSHAW/ [3/2002 vosraz2 Jat ImanzaPun __ |cwsasv27e002398 ie DV FOR THE [iov Fon TRAILER NON ELECTRICAL —+ 7 | SRG7EPS ties TOTAL VALUE ivewrcue SORES 1532580) a o o a isa EF ‘Owe Daman Policy Period Iie Paley Park. From Date B Time [27/06/2022 [To Oate & Time. [26/06/2023 25:55 |From Date & Te [ST/OG [tebe eine reroeraoas a 8:48 is of drug 8:48 fre ies of Midna i oo tora. IC TP cover {TOTAL PREMIUM PA FOR OWNER DRIVER ‘ADD : Sast/u ity Coverages For Paid ADD: CGST.00%% = Te TOTAL, Breer runeetsoe mamun sncluave ofa secs ondig/Oncouns ve (Aare Atocaen, Veurtary Excess, Art-Theft, ndeap Perc, PINS, Tuten rb las CNGILPG Un, Geographic xt, Impartes Wohi ke Wherever eppcabe |. ®A Gener Sree Conc Fs 2700/2022 To ish of Serb) 2003 ‘Subject fo InT Endorsement Printed herein ataced fo? 17-4, INT, 19723 ypethecation Aareamenk with: AY AVANT BA SINSADKSTOMA34915 ts Purshase/Leaee Aarsemnt wiht Under Sechon U1) esac of sy one ace: a8 er eto his At 646 esr Secon Ir) respect of any ene car or tres of cae ssnb crore evant eR, TEND 2A. Caver nde Sct it for Gua = Orwer (Ct) Re oa Denied Part KA\Sroken Port WA, Sethe Part: WA Clan et payed for: A Fromme Reso Driver cause ‘For NEFT/RTGS/IMPS or anyother online payment kindy vis ur website “wessshriramsicn”, autmsgeemessig or ontaniee ea anemia Peer Saat areas Qoa— ae =a Toll Free No.: 1800-300-30000, 1800-103-3009 | Fax: +81-141-2770692 /93,

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