1 E NE~v •. JIA ASSURANCE CO. LTO.

(Gov emn, ·Jnt of India Unde rtal,i ng)

\
Umitl ltions as to use
i)1 10e Poli~ _cover s use only unde r a perm
it within t he meaning of the
Limit s of U abTiitv
; ~or Ve •Cle.S Act. 1988 or such Umit of the amou nt the Company's
0 a carrla ie falling unde r Sub-sect,on Liabi lity Unde r Secti on 11 1(1) in
ect1on 66 of the Motor Vehic 3 respe<t or any one accid ent: as per the Moto
~<,ve , use FOR ii !Organised racinles
g
Act. 988.T he Poh;?,' does not
b)
of the amou nt of the Comp any'_ s Uabl
r Vehic les Act, 1988 . Llm,t
need Test, ng Pace Making c)Re ,ability Tnuls d) r espec t or ani li~ Unde_r Secti on 11 1(11) In .
one claim or sene s of cla ms arisin
Up to< 7.50. 00 g out or one even t.
For Indivi dual cover s (OD) In ?; 1290 000
Impos ed excess In ?:
0
Volun tarv excess In?;
0
Persons or class es or oen;ons entitl Compulsorv excess In?;
ed to drive 1500
f,ny perso n lnclud,n?i ~e insure d
provided that a person dr,ving holds
d,squahfied from ho ding or obta, nin an effec tive drivin g licens e at the
ven,e1e and u,at sucn a person sat,sP such a license. Provid ed also that the person holdin an effec tive t ime of the accid ent and Is not
ies the requi reme nt or Rule 3 of the Learn
PA cove< for Os·ine r Dnve r Centr al Moto r veilc les Rules. 1989 er's Licen se may also drive the
.

tlume or Nominee
Age of Nominee Relationship v11th the Name of the Appo intee (if Relat ionsh ip to the
none Insure d Nomi nee Is a mino r)
lo non~
Nomi nee
none none
?A cover fer name d <!rsons
' l ame
CSI Opted (?)
Nomi nee Relat ionsh i
t·U,
tlA NA
Pre?m,um an:.I GST D~tai ls

Rate of Tax Amou nt In INR

:remlum
' GST ~5192
:GST 9 467
: ST 9 467
0 0
·err :-1:TI
::;sr ~43037
6 2582
GST
;sr 6 2582
0 0

•. ·;,itness where of :Jus polic 'l has

ARRANTED Trit.T IM CASE Or OISHO been sioned at NIMAPARA BRANCH
on
, ,s pclic:y ,s sub;e ct to the Te,m s. IWU~ OF THi: PREMIU~'. CHEQUE, th,s 23/06/2021
Tl-115
10J/n ew,nd1a.co.1n; l~H Endo rsem con:ll t,ons and excep :,ons applicable to DOCUMENT STAMOS AUTOMATICALLY CANCELLED ABIN mO
ent Numb er(s) printed herew ith attac Package/Lia bility policy attac hed/a vaila ble on the web site
hed 21 .23.4 0.7.
,corta nt notice :
,e ir,sure :l ,sno t ,ndem nif,ed. ,r. tne vehic
mpan y by reason or w,der t erms appe le is us~d or dnve n other wise than ,n accor dance wilh this sched
anng in the cert,r icate in order to ule. Any
; uced: see daus e headed ·.1,vOIDAIK
OF CERTAIN TERMS AND RIGHTS comp ly with the Moto r Vehicles Act, 1988 paym ent made by the
e nee or otner prev,ous pohcy details Emade OF RECOVERY"' . It is clarif ied that 1s recov er aole from the
In case the decla ration rn9ard1ng
licv. v,ill stand forfei ted . by the insure d. ,s round t o be incor rect,
al1 lhe bene fits (Inclu ding cloim )
unde r sccti on·l of this
/ e ilen:by certif y that the policy to
lll as this Certi ficate cf. Insur ance Ylhich this Certif i~ate relate s as For and on beha lf of The New lndlil
: ~rov.stons of Oiap ter X and XI ofare issued In accor dance 1:1ith As:iu ran,c Compony Umi~ cd.
: AMC N4 1 65CST1B1 . M.V. Act. 1988 . tllA S.T.RE GM
te or lssu':! : 2Jto612021

Duly Cons titute d Attor ncyb )

Tax Invo ice Mo: 55010220P000061

9

Policy No.: 5S010231200100000S14 Occum

ent e ener.it ed by 39013 ol 23106/ 20211
Re¢. & He•d Office : Ntw lnd;o A:;suro 6:0S:2 3 Hour., ,
nt<! Bldg, a71,1.C. Ro•d. Fort, Mumb
:.crrl~ I of your gri~an ce, ,f ."Jny,yo o;• 400 001. TOLL FREE No. 1 800
u mJy ,3ppro xh any one or lhc follow 202 1~1~.
n g,r1nenc r ,~drt.s~al mtcha n,sm: :ng office , .. 1. Policy ls5ulng offic.c 2. Rcglon
you m.1y al-so approach tnsur:.nct JI omcc J, HC41'1 office.lo cue, you
Ombl.l':isman. For d r tails of our offica llrn nol :)i>tl:>OCNJ w1lh
addrc ,soi, and ee3d~ s,e.s of oNlc.e
vl!lt our \YllbSi11 hnpJlm:wind1a co.In. ot lnsur-'ince OmDudsnian, plea~r

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