https://

DR Go Digit General Insurance Ltd.

Schedule/Receipt
Digit Two-Wheeler Liability Only Policy
UIN No.: IRDAN158RP0003V01201718

N
Name ANKUSH NARENDRA DUDHBAVARE Vehicle Registration No. KA01HH4859
Address 119 Soujanya Enclave 6th Cross 29th Main Partner Name Direct
BTM 2nd Stage BNG 560076,Bengaluru- 1048212
560076 Partner Code

b
ia
Mobile xxxxxxxxx3098 Partner Mobile No. --

L
Email zxxxxxxxxo@gxxxl.com Partner Email support@godigit.com PB

er
Aadhar No. For Claims, contact us at 1800-258-5956

el
he
W
YOUR POLICY DETAILS

o-
Tw
Policy No. D083963964 / 27112022 Policy Issue Date 27-Nov-2022 Invoice No. IA080925760
1 From 28-Nov-2022 20:23:54

it
Period of Policy Policy Term 1 Year
27-Nov-2023 23:59:59

ig
To

D
CG From --
Invoice 27-Nov-2022
Period of Policy for PA Owner Driver

27
To -- Date

1-
PB YOUR VEHICLE DETAILS

-1
RTO location Bengaluru,KARNATAKA Make HONDA Model/Vehicle

23
Variant (Sub- ACTIVA/SCV 110

20
Engine No. JF50ET1556485 Chassis No. ME4JF502LET559254 Type)

28
Body Type Scooter Fuel Type Petrol Year of Regn 2014
DRS
G01 Seating

1-
59.76 2
Capacity Cubic Capacity 109 CC Year of Mfg. --

-1
FASTag Financier

22
Odometer
Number Details
20
VA

ENDORSEMENT
I
CT

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

IA080925760 2022-11-27 664.00 0.00 59.76 59.76 0.00 0.00 783.52

A
D
N

LIABILITY PREMIUM (`)

O

D
FH 664.00
H

Basic Third-Party Liability (`) PA cover for Owner-Driver (`) --

CGS
59

Age PA cover for 2 unamed passengers each 0 (`) -- PA cover for Paid Driver 0 (`) --
48

FH Legal Liability to Employees (`) -- Legal Liability to Paid Driver (`) --

H

Net Premium (`) 664.00

H

DRS CGST @ 9% = (`59.76 ) + SGST/UTGST @ 9% = (`59.76) 119.52

01
KA

(`)
RE

Final Premium 783.52

VA

OTHER DETAILS
BA

Previous Insurer -- Previous Policy No. --

H

N
D

IMT-20 Previous Policy --

IMT - Endorsements
U

Expiry Date
D

GSTIN/UIN No. Unregistered State Code 29

RA

Te
xt Receipt No. RA087835460 Receipt Date 27-Nov-2022
D

Nominee Details --
N
RE
A
N

Other Detials --
SH
KU

Geographical Area: Any liability incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and
N

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,
A

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 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 II - 1 (i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor
http Vehicles Act, 1988 and any subsequent amendment as applicable. 2) Under Section II - 1 (ii) of the policy: Damage to Third Party Property - (`
6000) 3) P.A. Cover for Owner Driver under Section III (CSI) -(`)(per annum).

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: Bengaluru Retail
Business Centre,Atlantis No 95 4th B Cross Road 5th Block Koramangala Industrial layout,Bangalore,Karnataka,PIN-560095
https://

DR Go Digit General Insurance Ltd.

Schedule/Receipt
Digit Two-Wheeler Liability Only Policy
UIN No.: IRDAN158RP0003V01201718

PA Owner Driver Declaration: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 Policy / already have an
alternate Personal Accident insurance cover of Rs. 15 Lakhs
Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.

PUC Declaration:The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before

b
the date of commencement of the Policy .Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in

ia
case of dishonor of Cheque or non-receipt of payment. Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of

L
Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages

er
under the Policy. The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment

el
made by the Company by reason of wider terms appearing in Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from

he
the insured. See the Clause headed (Avoidance Of Certain Terms And Right Of Recovery) in the policy. This policy is subject to the standard

W
policy wordings, warranties and conditions applicable for this product in addition to coverages and exclusions specified in the motor vehicle tariff

o-
published by IRDAI. Policy would be void on the ground that it was obtained by non- disclosure of material fact or by a representation of fact

Tw
Note: The policy is issued in utmost good faith, relying on the information shared by insured at the time of obtaining the policy. The terms and

it
conditions detailed in this policy schedule as well as the policy document sent by Digit shall prevail in case of any dispute.

ig
D
27
For & On Behalf of Go Digit General Insurance Ltd.

1-
-1
In case of claim or any other query, please

23
contact our 24-hour Call Centre at 1800-

20
258-5956 or email us at hello@godigit.com Praveen Bhat
Senior Vice President – Customer Experience
or visit our website www.godigit.com. praveen.bhat@godigit.com

28
Authorized Signatory
Printed, Signed, and Executed at Bengaluru

1-
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 ,

-1
Bengaluru- 560009 - KARNATAKA.

22
Hey, our document is now digitally signed
Click here to view the certificate.
20 For instant resolution, you can ping us “Hi”
on WhatsApp at 702 606 1234
I VA
CT
A
A
D
N
O
H
59
48
H
H
01
KA
RE
VA
BA
H
D
U
D
RA
D
N
RE
A
N
SH
KU
N
A

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: Bengaluru Retail
Business Centre,Atlantis No 95 4th B Cross Road 5th Block Koramangala Industrial layout,Bangalore,Karnataka,PIN-560095