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MA Go Digit General Insurance Ltd. Schedule/Receipt

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

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Name AJAHAR KHAN Vehicle Registration No. UP57Q7369
Address VIL RAMPUR MISHRI TOLAMISHRAULI PO Partner Name Girnar Insurance Brokers Private Ltd
ARJUN DUMARIPS HATA DIST 1000087
KUSHINAGAR,Kushinagar,Hata-274203 Partner Code

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Mobile xxxxxxxxx8580 Partner Mobile No. 7551196989

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Email pxxxxxxxxxxxxxxxxxk@gxxxl.com Partner Email support@insurancedekho.com PB

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

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Policy No. D047781034 / 21102021 Policy Issue Date 21-Oct-2021 Invoice No. IA050637338
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From 22-Oct-2021 14:04:21

Period of Policy Policy Term 1 Year
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To 21-Oct-2022 23:59:59
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M From -- Invoice 21-Oct-2021

FH Period of Policy for PA Owner Driver
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To -- Date
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YOUR VEHICLE DETAILS

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Kushinagar,UTTAR Model/Vehicle PASSION PRO/CAST DISC

PRADESH HERO MOTOCORP
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RTO location Make Variant (Sub- BRAKE ALLOY BSIV

Engine No. HA10ENDGE22079 Chassis No. MBLHA10AWDGE18127 Type)
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Body Type Motor Cycle Fuel Type Petrol Year of Regn 2013
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Seating
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Capacity Cubic Capacity 110 CC Year of Mfg. 2013
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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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IA050637338 2021-10-21 887.36 135.36 0.00 0.00 0.00 0.00 752.00

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LIABILITY PREMIUM (`)

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Basic Third-Party Liability (`) 752.00 PA cover for Owner-Driver (`) --

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-- PA cover for Paid Driver 0 (`) --

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PA cover for 2 unamed passengers each 0 (`)

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

Net Premium (`) 752.00
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IGST @ 18% = (`135.36) 135.36

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Final Premium (`) 887.36

OTHER DETAILS

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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
https://

MA Go Digit General Insurance Ltd. Schedule/Receipt

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

Previous Insurer -- Previous Policy No. --

Previous Policy
IMT - Endorsements -- Expiry Date --

GSTIN/UIN No. Unregistered State Code 9

Receipt No. RA052009870 Receipt Date 21-Oct-2021
Financier Details -- Nominee Details --

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Other Detials --

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

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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,

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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

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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

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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

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person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and any subsequent amendment as applicable. Limits of

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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

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Vehicles Act, 1988 and any subsequent amendment as applicable. 2) Under Section II - 1 (ii) of the policy: Damage to Third Party Property -

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(`100000) 3) P.A. Cover for Owner Driver under Section III (CSI) -(`)(per annum).

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PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of

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your declaration that you do not hold a valid Driving License on or before the date of commencement of this Policy / already have an

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alternate Personal Accident insurance cover of Rs. 15 Lakhs

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Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.

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

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

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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
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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
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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
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the insured. See the Clause headed (Avoidance Of Certain Terms And Right Of Recovery) in the policy. This policy is subject to the standard
policy wordings, warranties and conditions applicable for this product in addition to coverages and exclusions specified in the motor vehicle tariff
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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

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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For & On Behalf of Go Digit General Insurance Ltd.

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In case of claim or any other query, please

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contact our 24-hour C all C entre at 1800-

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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
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Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty has been paid as per Letter of
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Authorization No.67-B/04/2017-18 Date: 30th May 2017

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issued by Department of Stamps and Registration ,

Bengaluru- 560009 - KARNATAKA.
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Hey, our document is now digitally signed

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Click here to view the certificate.

For instant resolution, you can ping us “Hi”
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on WhatsApp at 702 606 1234

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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